Palliative care in heart failure

Abstract

Objectives: to analyze the current bibliography on the various aspects related to palliative care implementation for advanced heart failure (AHF) to know the prognosis and trajectory of disease in AHF, patient needs, and the most significant measures to be adopted from an improved quality of life standpoint-Material and methods: a narrative review focused on the available references on AHF prognostic criteria, patient needs, palliative care integration into comprehensive HF care, and evidence-based HF care inclusion in end-of-life care for HF patients and symptom management. Results: prognostication in AHF is difficult and this is the main reason why these patients are not included in palliative care programs. These patients are heterogeneous, and an exhaustive evaluation is needed, mainly regarding prognostic factors (heart disease, comorbidity, functional situation, and fragility data) before decision-making. Risk stratification is uncertain and limited data validate the use of available prognostic indicators in advanced HF. Medical therapies, as articulated in guidelines for heart failure management should be optimized for all individuals with AHF to achieve symptom control. Yet there is a paucity of evidence with which to address palliation of refractory AHF symptoms. The care of patients with AHF should include information about the medical condition and the possibility of patient decisions regarding potential interventions. Conclusions: palliative care programs should include patients with ICA and focus on improving their quality of life. Research is needed to identify which interventions improve quality of life. Copyright © 2010 Arán Ediciones, S.l.