The First Steps Taken to Implement Palliative Care in Advanced Heart Disease: A Position Statement from Denmark
- 1 September 2020
- journal article
- research article
- Published by Mary Ann Liebert Inc in Journal of Palliative Medicine
- Vol. 23 (9), 1159-1166
- https://doi.org/10.1089/jpm.2019.0566
Abstract
According to the World Health Organization, palliative care must be available for everyone with life-threatening diseases. However, in daily practice the primary focus worldwide is on cancer patients. The aim of the article was to generate a national position statement as the first step in implementing palliative care in severe heart disease with focus on advanced heart failure, including tools to identify the need for and timing of palliative care and how palliative care could be organized in Denmark. A task force was formed in the Danish Society of Cardiology Heart Failure Working Group, and the position statement was prepared in collaboration with members from a broad group of specialties, including palliative medicine. Because of major gaps in evidence, the position statement was based on small and low-quality studies and clinical practice statements. This position statement was aligned with the European Society of Cardiology recommendation, focusing on relieving suffering from the early disease stages parallel to standard care and supplementing life-prolonging treatment. The statement delivers practical guidance on clinical aspects and managing symptoms during the three stages of advanced heart disease. Furthermore, the statement describes the importance of communication and topics to be broached, including deactivating implantable cardioverter defibrillators. The statement recommends a targeted effort on organizational strategies using high-quality assessment tools and emphasizes multidisciplinary and intersectoral collaboration. Danish cardiologists supported by allied professionals acknowledge the importance of palliative care in advanced heart disease. This national position statement intended to inform and influence policy and practice and can hopefully inspire other countries to take action toward implementing palliative care in advanced heart disease.Keywords
This publication has 70 references indexed in Scilit:
- Adherence to placebo and mortality in the Beta Blocker Evaluation of Survival Trial (BEST)Contemporary Clinical Trials, 2012
- A new model for integrated heart failure and palliative advanced homecare − rationale and design of a prospective randomized studyEuropean Journal of Cardiovascular Nursing, 2012
- Giving Voice to Patients' and Family Caregivers' Needs in Chronic Heart Failure: Implications for Palliative Care ProgramsJournal of Palliative Medicine, 2011
- End-of-life care conversations with heart failure patients: a systematic literature review and narrative synthesisBritish Journal of General Practice, 2011
- Changing Preferences for Survival After Hospitalization With Advanced Heart FailureJournal of the American College of Cardiology, 2008
- Depression and Coronary Heart DiseaseCirculation, 2008
- Care for all at the end of lifeBMJ, 2008
- Increased Satisfaction with Care and Lower Costs: Results of a Randomized Trial of In‐Home Palliative CareJournal of the American Geriatrics Society, 2007
- Depression in Heart Failure: A Meta-Analytic Review of Prevalence, Intervention Effects, and Associations With Clinical OutcomesJournal of the American College of Cardiology, 2006
- The Effect of Spironolactone on Morbidity and Mortality in Patients with Severe Heart FailureNew England Journal of Medicine, 1999