Integrating palliative care into heart failure care.
Heart failure is a condition for which both palliative care and hospice care can be appropriate. The disease's increasing prevalence and predilection for elderly patients with significant comorbidity underscore the need to integrate these modes of care with the acute care approach that has dominated heart failure treatment. We propose integration of a palliative care approach early in the course of heart failure treatment and a tiered process for selecting patients for hospice care. A transition of the focus to palliative care rather than mortality reduction should occur over time, when clinical status deteriorates and advanced therapeutic options become inappropriate or ineffective. Failure to respond to the need for palliative care puts at risk the mandate to treat the patient with heart failure during the entire course of illness.
Hauptman
Paul J
PJ
Division of Cardiology, Saint Louis University School of Medicine, St Louis, MO 63110, USA. hauptmpj@slu.edu
Havranek
Edward P
EP
D000368:Aged; D003153:Community Health Services; D003266:Continuity of Patient Care; D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D019468:Disease Management; D006302:Health Services Research; D006333:Heart Failure / Q000401:mortality / Q000628:therapy*; D017051:Hospice Care / Q000458:organization & administration; D006801:Humans; D007373:Interinstitutional Relations; D020380:Needs Assessment; D010166:Palliative Care / Q000458:organization & administration*; D011379:Prognosis; D012189:Retrospective Studies; D019452:Terminally Ill; D014481:United States