Abstract
Background
A consensus conference was convened to define the current state and important gaps
in knowledge and needed research on “Palliative and Supportive Care in Advanced Heart
Failure.”
Evidence
Evidence was drawn from expert opinion and from extensive review of the medical literature,
evidence-based guidelines, and reviews.
Conclusions
The conference identified gaps in current knowledge, practice, and research relating
to prognostication, symptom management, and supportive care for advanced heart failure
(HF). Specific conclusions include: (1) although supportive care should be integrated
throughout treatment of patients with advanced HF, data are needed to understand how
to best decrease physical and psychosocial burdens of advanced HF and to meet patient
and family needs; (2) prognostication in advanced HF is difficult and data are needed
to understand which patients will benefit from which interventions and how best to
counsel patients with advanced HF; (3) research is needed to identify which interventions
improve quality of life and best achieve the outcomes desired by patients and family
members; (4) care should be coordinated between sites of care, and barriers to evidence-based
practice must be addressed programmatically; and (5) more research is needed to identify
the content and technique of communicating prognosis and treatment options with patients
with advanced HF; physicians caring for patients with advanced HF must develop skills
to better integrate the patient's preferences into the goals of care.
Keywords
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Article info
Publication history
Accepted:
September 16,
2003
Received in revised form:
September 15,
2003
Received:
August 13,
2003
Salt Lake City, Utah; Saint Louis, Missouri; Pittsburgh, Pennsylvania; Chicago Illinois; Portland, Oregon; Denver, Colorado; Kansas City, Missouri; San Francisco, California; Madison, Wisconsin; Cleveland, Ohio; Emeryville, California; Grand Junction, Colorado; Minnetonka, Minnesota; Providence, Rhode IslandFootnotes
☆Funded by the Agency for Healthcare Research and Quality (R13 HS13804-01) and the Robert Wood Johnson Foundation (044913).
☆∗Perspectives reflect the views of the author(s) and are not necessarily the views of the Editors of the Journal of Cardiac Failure or the Heart Failure Society of America.
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
