Inpatient palliative care visits associated with improved quality of life for patients with heart failure

A recent randomized trial conducted by researchers at Abbott Northwestern Hospital, part of Allina Health, found that inpatient palliative care (PC) visits were associated with improved quality of life and symptom burden for patients with heart failure (HF).

Because of these results, Abbott Northwestern conducted a new study, "A Description of Inpatient Palliative Care Actions for Patients with Acute Heart Failure," published June 30 by the American Journal of Hospice and Palliative Medicine. The study aimed to identify and describe what actions PC providers took to create positive outcomes among study patients in the trial.

Models for improved integration of PC into standard HF care have been suggested and included in the American College of Cardiologists and American Heart Association (ACC/ AHA) guidelines but little information is available about implementation of such models. Because much of the existing research on PC for HF focuses on patients with advanced or late-stage disease, gaps exist in evidence-based knowledge about the role of PC for patients with less advanced HF.

This is one of the first studies to describe the actions of PC providers for inpatients with acute HF, regardless of disease progression and without a referral from another clinician identifying PC needs. The findings show that PC for inpatients with HF led to additive actions beyond standard care, especially for pain, and promoted HF-specific goals of care discussions.

"More than five million Americans are living with HF and almost 50 percent will die within five years of the diagnosis. HF is a disease characterized by hospitalizations and varying degrees of symptoms like shortness of breath, swollen ankles and fatigue.

"Adding PC to usual care not only assists with minimizing symptoms, but perhaps and even more importantly, starts the conversation about HF specific goals of care and future care planning. Providing the opportunity for HF patients to receive PC is one way Allina Health honors their commitment of providing exceptional care," said Ann Jorgenson, RN, lead author and researcher with the Division of Applied Research of Allina Health.

This peer-reviewed article discusses how symptom burden and complex decision-making faced by patients with HF are important and may contribute to overall health status, quality of life, and likelihood of readmission. The publication describes next steps for the future of this PC research.

"Developing a systematic approach to identifying patients with PC needs and sustaining access to PC across the course of illness may provide opportunities for providers to more adequately address symptoms of anxiety and depression and facilitate future care planning," said Jorgenson.