title: Consensus statement: Palliative and supportive care in advanced heart failure.
abstract: 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.
authors.affiliation: Institute for Health Care Delivery and Research, Intermountain Health Care, Salt Lake City, Utah 84111, USA.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Goodlin
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Hauptman
authors.forename: Robert
authors.initials: R
authors.lastname: Arnold
authors.forename: Kathleen
authors.initials: K
authors.lastname: Grady
authors.forename: Ray E
authors.initials: RE
authors.lastname: Hershberger
authors.forename: Jean
authors.initials: J
authors.lastname: Kutner
authors.forename: Frederick
authors.initials: F
authors.lastname: Masoudi
authors.forename: John
authors.initials: J
authors.lastname: Spertus
authors.forename: Kathleen
authors.initials: K
authors.lastname: Dracup
authors.forename: James F
authors.initials: JF
authors.lastname: Cleary
authors.forename: Ruth
authors.initials: R
authors.lastname: Medak
authors.forename: Kathy
authors.initials: K
authors.lastname: Crispell
authors.forename: Ileana
authors.initials: I
authors.lastname: Piña
authors.forename: Brad
authors.initials: B
authors.lastname: Stuart
authors.forename: Christy
authors.initials: C
authors.lastname: Whitney
authors.forename: Thomas
authors.initials: T
authors.lastname: Rector
authors.forename: Joan
authors.initials: J
authors.lastname: Teno
authors.forename: Dale G
authors.initials: DG
authors.lastname: Renlund
mesh_terms: 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