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      Social Worker–Aided Palliative Care Intervention in High-risk Patients With Heart Failure (SWAP-HF) : A Pilot Randomized Clinical Trial

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          Abstract

          Palliative care considerations are typically introduced late in the disease trajectory of patients with advanced heart failure (HF), and access to specialty-level palliative care may be limited.

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          Advanced (stage D) heart failure: a statement from the Heart Failure Society of America Guidelines Committee.

          James C Fang, Gregory Ewald, Larry A Allen … (2015)
          We propose that stage D advanced heart failure be defined as the presence of progressive and/or persistent severe signs and symptoms of heart failure despite optimized medical, surgical, and device therapy. Importantly, the progressive decline should be primarily driven by the heart failure syndrome. Formally defining advanced heart failure and specifying when medical and device therapies have failed is challenging, but signs and symptoms, hemodynamics, exercise testing, biomarkers, and risk prediction models are useful in this process. Identification of patients in stage D is a clinically important task because treatments are inherently limited, morbidity is typically progressive, and survival is often short. Age, frailty, and psychosocial issues affect both outcomes and selection of therapy for stage D patients. Heart transplant and mechanical circulatory support devices are potential treatment options in select patients. In addition to considering indications, contraindications, clinical status, and comorbidities, treatment selection for stage D patients involves incorporating the patient's wishes for survival versus quality of life, and palliative and hospice care should be integrated into care plans. More research is needed to determine optimal strategies for patient selection and medical decision making, with the ultimate goal of improving clinical and patient centered outcomes in patients with stage D heart failure.
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            Palliative care referral among patients hospitalized with advanced heart failure.

            Daniel T Greener, Timothy A. Quill, Offer Amir … (2014)
            Many heart failure (HF) patients experience high symptom burden, but palliative care (PC) services have been used infrequently in this population.
            Article 0 comments Cited 16 times – based on 0 reviews     Review now
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              Discharge Hospice Referral and Lower 30-Day All-Cause Readmission in Medicare Beneficiaries Hospitalized for Heart FailureCLINICAL PERSPECTIVE

              Sridivya Parvataneni, Steven Singh, Charity Morgan … (2015)
              Heart failure (HF) is the leading cause for hospital readmission. Hospice care may help palliate HF symptoms but its association with 30-day all-cause readmission remains unknown.
              Article 0 comments Cited 10 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Title: JAMA Cardiology
                Abbreviated Title: JAMA Cardiol
                Publisher: American Medical Association (AMA)
                ISSN (Print): 2380-6583
                Publication date Created: June 01 2018
                Publication date (Print): June 01 2018
                Volume: 3
                Issue: 6
                Page: 516
                Affiliations
                [1 ]Boston University School of Social Work, Boston, Massachusetts
                [2 ]Palliative Medicine Division, Brigham and Women’s Hospital, Boston, Massachusetts
                [3 ]Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
                [4 ]Department of Social Work, Brigham and Women’s Hospital, Boston, Massachusetts
                [5 ]Cardiovascular Division, Brigham and Women’s Hospital, Boston, Massachusetts
                Article
                DOI: 10.1001/jamacardio.2018.0589
                PMC ID: 6128511
                PubMed ID: 29641819
                SO-VID: 13943ec0-9185-498d-8c9a-d21d189bdd81
                Copyright © © 2018
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