A comparative study of the palliative care needs of heart failure and cancer patients.
OBJECTIVE
Studies suggest that patients with advanced heart failure (HF) have unmet palliative care (PC) needs. However, many of these studies have been retrospective or based on patients receiving poorly coordinated ad hoc care. We aimed to demonstrate whether the PC needs of patients with advanced HF receiving specialist multidisciplinary coordinated care are similar to cancer patients deemed to have specialist PC needs; thereby justifying the extension of specialist PC services to HF patients.


RESULTS
This was a cross-sectional comparative cohort study of 50 HF patients and 50 cancer patients, using quantitative and qualitative methods. Both patient cohorts were statistically indistinguishable in terms of symptom burden, emotional wellbeing, and quality-of-life scores. HF patients had good access to community and social support. HF patients particularly valued the close supervision, medication monitoring, ease of access to service, telephone support, and key worker provided at the HF unit. A small subset of patients had unmet PC needs. A palliative transition point is described.


CONCLUSIONS
HF patients should not be excluded from specialist PC services. However, the majority of their needs can be met at a HF unit. Recognition of the palliative transition point may be key to ensuring that end-of-life issues are addressed. The palliative transition point needs further evaluation.
O'Leary
Norma
N
Department of Palliative Medicine, St Vincent's University Hospital, Dublin, Ireland. normaoleary@hotmail.com
Murphy
Niamh F
NF
O'Loughlin
Christina
C
Tiernan
Eoin
E
McDonald
Kenneth
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006301:Health Services Needs and Demand; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000523:psychology / Q000628:therapy*; D010166:Palliative Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome