Prevalence and characteristics of patients with heart failure needing palliative care

Abstract Background Few hospitals and heart failure (HF) clinics offer concurrent palliative care (PC) together with life-prolonging therapies. To know the prevalence of patients in HF clinics needing PC and useful tools to recognize them are the first steps to extending PC in those settings. Howeve...

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Autores principales:	Luisa Fernanda Arenas Ochoa, Valentina González-Jaramillo, Clara Saldarriaga, Mariantonia Lemos, Alicia Krikorian, John Jairo Vargas, Xavier Gómez-Batiste, Nathalia Gonzalez-Jaramillo, Steffen Eychmüller
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Heart failure Palliative care Needs assessment Prognosis Patient-centered care Health services needs and demands Special situations and conditions RC952-1245
Acceso en línea:	https://doaj.org/article/50611b4ed07e454480b177bde29fb77a
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spelling	oai:doaj.org-article:50611b4ed07e454480b177bde29fb77a2021-12-05T12:08:02ZPrevalence and characteristics of patients with heart failure needing palliative care10.1186/s12904-021-00850-y1472-684Xhttps://doaj.org/article/50611b4ed07e454480b177bde29fb77a2021-12-01T00:00:00Zhttps://doi.org/10.1186/s12904-021-00850-yhttps://doaj.org/toc/1472-684XAbstract Background Few hospitals and heart failure (HF) clinics offer concurrent palliative care (PC) together with life-prolonging therapies. To know the prevalence of patients in HF clinics needing PC and useful tools to recognize them are the first steps to extending PC in those settings. However, it is still unknown whether tools commonly used to identify patients with HF needing PC can correctly distinguish them. Two systematic reviews found that the NECesidades PALiativas (NECPAL) tool was one of the two most commonly used tools to asses PC needs in HF patients. Therefore, we assessed 1) the prevalence of PC needs in HF clinics according to the NECPAL tool, and 2) the characteristics of the patients identified as having PC; mainly, their quality of life (QoL), symptom burden, and psychosocial problems. Methods This cross-sectional study was conducted at two HF clinics in Colombia. We assessed the prevalence of PC in the overall sample and in subgroups according to clinical and demographic variables. We assessed QoL, symptom burden, and psychosocial problems using the 12-Item Short-Form Health Survey (SF-12), the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Edmonton Symptom Assessment System (ESAS). We compared the results of these tools between patients identified as having PC needs (+NECPAL) and patients identified as not having PC needs (–NECPAL). Results Among the 178 patients, 78 (44%) had PC needs. The prevalence of PC needs was twice as nigh in patients NYHA III/IV as in patients NYHA I/II and almost twice as high in patients older than 70 years as in patients younger than 70 years. Compared to –NECPAL patients, +NECPAL patients had worse QoL, more severe shortness of breath, tiredness, drowsiness, and pain, and more psychosocial problems. Conclusion The prevalence of PC needs in outpatient HF clinics is high and is even higher in older patients and in patients at more advanced NYHA stages. Compared to patients identified as not having PC needs, patients identified as having PC needs have worse QoL, more severe symptoms, and greater psychosocial problems. Including a PC provider in the multidisciplinary team of HF clinics may help to assess and cover these needs.Luisa Fernanda Arenas OchoaValentina González-JaramilloClara SaldarriagaMariantonia LemosAlicia KrikorianJohn Jairo VargasXavier Gómez-BatisteNathalia Gonzalez-JaramilloSteffen EychmüllerBMCarticleHeart failurePalliative careNeeds assessmentPrognosisPatient-centered careHealth services needs and demandsSpecial situations and conditionsRC952-1245ENBMC Palliative Care, Vol 20, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Heart failure Palliative care Needs assessment Prognosis Patient-centered care Health services needs and demands Special situations and conditions RC952-1245
spellingShingle	Heart failure Palliative care Needs assessment Prognosis Patient-centered care Health services needs and demands Special situations and conditions RC952-1245 Luisa Fernanda Arenas Ochoa Valentina González-Jaramillo Clara Saldarriaga Mariantonia Lemos Alicia Krikorian John Jairo Vargas Xavier Gómez-Batiste Nathalia Gonzalez-Jaramillo Steffen Eychmüller Prevalence and characteristics of patients with heart failure needing palliative care
description	Abstract Background Few hospitals and heart failure (HF) clinics offer concurrent palliative care (PC) together with life-prolonging therapies. To know the prevalence of patients in HF clinics needing PC and useful tools to recognize them are the first steps to extending PC in those settings. However, it is still unknown whether tools commonly used to identify patients with HF needing PC can correctly distinguish them. Two systematic reviews found that the NECesidades PALiativas (NECPAL) tool was one of the two most commonly used tools to asses PC needs in HF patients. Therefore, we assessed 1) the prevalence of PC needs in HF clinics according to the NECPAL tool, and 2) the characteristics of the patients identified as having PC; mainly, their quality of life (QoL), symptom burden, and psychosocial problems. Methods This cross-sectional study was conducted at two HF clinics in Colombia. We assessed the prevalence of PC in the overall sample and in subgroups according to clinical and demographic variables. We assessed QoL, symptom burden, and psychosocial problems using the 12-Item Short-Form Health Survey (SF-12), the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Edmonton Symptom Assessment System (ESAS). We compared the results of these tools between patients identified as having PC needs (+NECPAL) and patients identified as not having PC needs (–NECPAL). Results Among the 178 patients, 78 (44%) had PC needs. The prevalence of PC needs was twice as nigh in patients NYHA III/IV as in patients NYHA I/II and almost twice as high in patients older than 70 years as in patients younger than 70 years. Compared to –NECPAL patients, +NECPAL patients had worse QoL, more severe shortness of breath, tiredness, drowsiness, and pain, and more psychosocial problems. Conclusion The prevalence of PC needs in outpatient HF clinics is high and is even higher in older patients and in patients at more advanced NYHA stages. Compared to patients identified as not having PC needs, patients identified as having PC needs have worse QoL, more severe symptoms, and greater psychosocial problems. Including a PC provider in the multidisciplinary team of HF clinics may help to assess and cover these needs.
format	article
author	Luisa Fernanda Arenas Ochoa Valentina González-Jaramillo Clara Saldarriaga Mariantonia Lemos Alicia Krikorian John Jairo Vargas Xavier Gómez-Batiste Nathalia Gonzalez-Jaramillo Steffen Eychmüller
author_facet	Luisa Fernanda Arenas Ochoa Valentina González-Jaramillo Clara Saldarriaga Mariantonia Lemos Alicia Krikorian John Jairo Vargas Xavier Gómez-Batiste Nathalia Gonzalez-Jaramillo Steffen Eychmüller
author_sort	Luisa Fernanda Arenas Ochoa
title	Prevalence and characteristics of patients with heart failure needing palliative care
title_short	Prevalence and characteristics of patients with heart failure needing palliative care
title_full	Prevalence and characteristics of patients with heart failure needing palliative care
title_fullStr	Prevalence and characteristics of patients with heart failure needing palliative care
title_full_unstemmed	Prevalence and characteristics of patients with heart failure needing palliative care
title_sort	prevalence and characteristics of patients with heart failure needing palliative care
publisher	BMC
publishDate	2021
url	https://doaj.org/article/50611b4ed07e454480b177bde29fb77a
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Prevalence and characteristics of patients with heart failure needing palliative care

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