Consensus statement: Palliative and supportive care in advanced heart failure.
BACKGROUND
A consensus conference was convened to define the current state and important gaps in knowledge and needed research on "Palliative and Supportive Care in Advanced Heart Failure."


METHODS
Evidence was drawn from expert opinion and from extensive review of the medical literature, evidence-based guidelines, and reviews.


CONCLUSIONS
The conference identified gaps in current knowledge, practice, and research relating to prognostication, symptom management, and supportive care for advanced heart failure (HF). Specific conclusions include: (1) although supportive care should be integrated throughout treatment of patients with advanced HF, data are needed to understand how to best decrease physical and psychosocial burdens of advanced HF and to meet patient and family needs; (2) prognostication in advanced HF is difficult and data are needed to understand which patients will benefit from which interventions and how best to counsel patients with advanced HF; (3) research is needed to identify which interventions improve quality of life and best achieve the outcomes desired by patients and family members; (4) care should be coordinated between sites of care, and barriers to evidence-based practice must be addressed programmatically; and (5) more research is needed to identify the content and technique of communicating prognosis and treatment options with patients with advanced HF; physicians caring for patients with advanced HF must develop skills to better integrate the patient's preferences into the goals of care.
Goodlin
Sarah J
SJ
Institute for Health Care Delivery and Research, Intermountain Health Care, Salt Lake City, Utah 84111, USA.
Hauptman
Paul J
PJ
Arnold
Robert
R
Grady
Kathleen
K
Hershberger
Ray E
RE
Kutner
Jean
J
Masoudi
Frederick
F
Spertus
John
J
Dracup
Kathleen
K
Cleary
James F
JF
Medak
Ruth
R
Crispell
Kathy
K
Piña
Ileana
I
Stuart
Brad
B
Whitney
Christy
C
Rector
Thomas
T
Teno
Joan
J
Renlund
Dale G
DG
D003376:Counseling; D003657:Decision Making; D017048:Health Care Costs; D006333:Heart Failure / Q000523:psychology / Q000628:therapy*; D006801:Humans; D017063:Outcome Assessment, Health Care; D010166:Palliative Care / Q000191:economics; D010348:Patient Care Team; D011788:Quality of Life