• Sarah J Goodlin, Paul J Hauptman, Robert Arnold, Kathleen Grady, Ray E Hershberger, Jean Kutner, Frederick Masoudi, John Spertus, Kathleen Dracup, James F Cleary, Ruth Medak, Kathy Crispell, Ileana Piña, Brad Stuart, Christy Whitney, Thomas Rector, Joan Teno, and Dale G Renlund.
• Institute for Health Care Delivery and Research, Intermountain Health Care, Salt Lake City, Utah 84111, USA.
• J. Card. Fail. 2004 Jun 1;10(3):200-9.

BackgroundA 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."EvidenceEvidence was drawn from expert opinion and from extensive review of the medical literature, evidence-based guidelines, and reviews.ConclusionsThe 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.

12 keywords...

hide…