• J Pain Symptom Manage · Dec 2024

    Identifying palliative care needs in patients with heart failure using patient reported outcomes.

    • Camilla Lykke, Birgit Jurlander, Ola Ekholm, Per Sjøgren, Gitte Irene Juhl, Geana Paula Kurita, Sille Larsen, Niels Tønder, Lene Vibe Høyer, Inge Eidemak, and Ann-Dorthe Zwisler.
    • Department of Oncology and Palliative Care (C.L, G.I.J, S.L, L.V.H), North Zealand Hospital, Hillerød, Denmark; Section of Palliative Medicine (C.L, P.S, G.P.K, I.E, A-D.Z), Department of Oncology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark. Electronic address: Camilla.charlotte.lykke.01@regionh.dk.
    • J Pain Symptom Manage. 2024 Dec 1; 68 (6): 561572561-572.

    ContextHeart failure (HF) is considered a multifaceted and life-threatening syndrome characterized by high symptom-burden and significant mortality.ObjectivesTo describe the symptom-burden in patients with HF and identify their palliative care needs. In this respect, symptom burden related to sex, age and classification of HF using New York Heart Association Functional Classification (NYHA) were analyzed.MethodsA cross-sectional questionnaire survey included adult HF patients according to NYHA II, III, and IV. Palliative care needs were assessed using validated patient reported outcomes measures; SF-36v1, HeartQoL, EORTC- QLQ-C15-PAL, MFI-20 and HADS. Patients were recruited from the Department of Cardiology, North Zealand Hospital, Denmark.ResultsIn total, 314 patients (79%) completed the questionnaire (233 men). Mean age = 74 years (range 35-94 years). In all, 42% had NYHA III or IV and 53% self-rated their health to be fair or poor. In all, 19% NYHA II and 67% NYHA III/IV patients had ≥4 severe palliative symptoms according to EORTC-QLQ-C15-PAL. In addition, NYHA III/IV had a mean of 8.9 symptoms and a mean of 5.4 severe symptoms. Women, older patients, and those with NYHA III/IV had worse outcomes regarding health-related quality of life, functional capacity, and symptom burden.ConclusionsPatients with HF have a high prevalence of symptoms and, thus, potential palliative care needs. Predominantly, women, older patients, and those with higher severity of disease have the highest symptom burden. PROMs can help cardiologists address the palliative care needs and systematic assessment may be a prerequisite to integrate symptom-modifying and palliative care interventions.Copyright © 2024 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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