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Review
. 2024 Jun;12(6):973-989.
doi: 10.1016/j.jchf.2024.01.010. Epub 2024 Mar 6.

Palliative Care Across the Spectrum of Heart Failure

Laura P Gelfman  1 , Moritz Blum  2 , Modele O Ogunniyi  3 , Colleen K McIlvennan  4 , Dio Kavalieratos  5 , Larry A Allen  4
Affiliations
Free article
Review

Palliative Care Across the Spectrum of Heart Failure

Laura P Gelfman et al. JACC Heart Fail. 2024 Jun.
Free article

Abstract

Persons with heart failure (HF) often suffer from poor symptom control, decreased quality of life, and poor communication with their health care providers. These needs are particularly acute in advanced HF, a leading cause of death in the United States. Palliative care, when offered alongside HF disease management, offers improved symptom control, quality of life, communication, and caregiver satisfaction as well as reduced caregiver anxiety. The dynamic nature of the clinical trajectory of HF presents distinct symptom patterns, changing functional status, and uncertainty, which requires an adaptive, dynamic model of palliative care delivery. Due to a limited specialty-trained palliative care workforce, patients and their caregivers often cannot access these benefits, especially in the community. To meet these needs, new models are required that are better informed by high-quality data, engage a range of health care providers in primary palliative care principles, and have clear triggers for specialty palliative care engagement, with specific palliative interventions tailored to patient's illness trajectory and changing needs.

Keywords: heart failure; palliative care; quality of life.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Gelfman has received support from the Claude D. Pepper Older Americans Independence Center at the Icahn School of Medicine at Mount Sinai (5P30AG028741) and the Sojourns Scholars Leadership Award from the Cambia Health Foundation. Dr Ogunniyi has received institutional research support grants from AstraZeneca, Boehringer Ingelheim, Cardurion Pharmaceuticals, and Pfizer, outside of the submitted work. Dr Kavalieratos has served as a member of the Board of Directors of the American Academy of Hospice and Palliative Medicine. Dr Allen has received research funding from the National Institutes of Health and Patient-Centered Outcomes Research Institute; and has received consulting fees from ACI Clinical, American Heart Association, Boston Scientific, Cytokinetics, Medscape, Novartis, Quidel, and UpToDate. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.