Author + information
- Received June 14, 2017
- Revision received July 28, 2017
- Accepted August 21, 2017
- Published online October 2, 2017.
- Dio Kavalieratos, PhDa,∗ (, )
- Laura P. Gelfman, MD, MPHb,c,
- Laura E. Tycon, MSN, CRNPd,
- Barbara Riegel, PhD, RNe,
- David B. Bekelman, MD, MPHf,
- Dara Z. Ikejiani, BSa,
- Nathan Goldstein, MDb,
- Stephen E. Kimmel, MD, MSCEg,
- Marie A. Bakitas, DNSc, CRNPh and
- Robert M. Arnold, MDa
- aDepartment of Medicine, Division of General Internal Medicine, Section of Palliative Care and Medical Ethics, University of Pittsburgh, Pittsburgh, Pennsylvania
- bBrookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
- cGeriatric Research Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, New York
- dUniversity of Pittsburgh Medical Center Palliative and Supportive Institute, Pittsburgh, Pennsylvania
- eSchool of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
- fDepartment of Medicine, University of Colorado School of Medicine at the Anschutz Medical Campus, Aurora, Colorado
- gCenter for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- hSchool of Nursing, University of Alabama at Birmingham, Birmingham, Alabama
- ↵∗Address for correspondence:
Dr. Dio Kavalieratos, Department of Medicine, Division of General Internal Medicine, Section of Palliative Care and Medical Ethics, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, Pennsylvania 15213.
Patients with heart failure (HF) and their families experience stress and suffering from a variety of sources over the course of the HF experience. Palliative care is an interdisciplinary service and an overall approach to care that improves quality of life and alleviates suffering for those living with serious illness, regardless of prognosis. In this review, we synthesize the evidence from randomized clinical trials of palliative care interventions in HF. While the evidence base for palliative care in HF is promising, it is still in its infancy and requires additional high-quality, methodologically sound studies to clearly elucidate the role of palliative care for patients and families living with the burdens of HF. Yet, an increase in attention to primary palliative care (e.g., basic physical and emotional symptom management, advance care planning), provided by primary care and cardiology clinicians, may be a vehicle to address unmet palliative needs earlier and throughout the illness course.
The contents of this article do not represent the views of the U.S. Department of Veterans Affairs or the United States Government. Dr. Kavalieratos receives research support from the National Heart, Lung, and Blood Institute (grant K01-HL133466). Dr. Gelfman was supported by a K23 grant from the National Institute on Aging (K23-AG049930). Dr. Bekelman receives research support from the Department of Veterans Affairs and the Veterans Affairs Eastern Colorado Health Care System. Dr. Goldstein is supported by funds from the Mount Sinai Claude D. Pepper Older Americans Independence Center (grant P30-AG028741) and a grant from the National Heart, Lung, and Blood Institute (R01-HL102084). Dr. Bakitas is supported by a grant from the National Institute of Nursing Research (R01-NR013665). IMPACT-HF2 (Improve Palliative Care Therapies for Patients with Heart Failure and Their Families), a working group of palliative care and heart failure experts, was supported by the American Federation for Aging Research, the John A. Hartford Foundation, the National Palliative Care Research Center, Mount Sinai’s Claude Pepper Older American Independence Center (grant P30-AG028741), and University of Alabama at Birmingham Centers for Comprehensive Cardiovascular Care and Palliative and Supportive Care. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Michele A. Hamilton, MD, served as Guest Editor for this paper.
- Received June 14, 2017.
- Revision received July 28, 2017.
- Accepted August 21, 2017.
- Central Illustration
- Natural Opportunities to Integrate Palliative Domains in HF Care
- Review of Randomized Clinical Trials of Palliative Care in HF
- Existing Clinical Guidelines Regarding Palliative Care in HF
- Priorities for Future Research and Clinical Implementation of Palliative Care in HF