Congestive heart failure end-of-life considerations: Difference between revisions
Jump to navigation
Jump to search
(/* Congestive heart failure end-of-life considerations (DO NOT EDIT){{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 18 | pages= e876-e894 | pmid=35363500 | doi=...) |
(/* Palliative and Supportive Care, Shared Decision-Making, and End-of-Life (DO NOT EDIT) {{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 18 | pages= e876-e894 |...) |
||
| Line 37: | Line 37: | ||
|colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | |colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | ||
|- | |- | ||
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>''' | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.'''For patients with HF- particularly stage D HF patients being evaluated for advanced therapies, patients requiring inotropic support or temporary mechanical support, patients experiencing uncontrolled symptoms, major medical decisions, or multimorbidity, frailty, and cognitive impairment - specialist palliative care consultation can be useful to improve QOL and relieve suffering. <ref name="pmid28705314">{{cite journal| author=Rogers JG, Patel CB, Mentz RJ, Granger BB, Steinhauser KE, Fiuzat M | display-authors=etal| title=Palliative Care in Heart Failure: The PAL-HF Randomized, Controlled Clinical Trial. | journal=J Am Coll Cardiol | year= 2017 | volume= 70 | issue= 3 | pages= 331-341 | pmid=28705314 | doi=10.1016/j.jacc.2017.05.030 | pmc=5664956 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28705314 }} </ref><ref name="pmid29482218">{{cite journal| author=Bekelman DB, Allen LA, McBryde CF, Hattler B, Fairclough DL, Havranek EP | display-authors=etal| title=Effect of a Collaborative Care Intervention vs Usual Care on Health Status of Patients With Chronic Heart Failure: The CASA Randomized Clinical Trial. | journal=JAMA Intern Med | year= 2018 | volume= 178 | issue= 4 | pages= 511-519 | pmid=29482218 | doi=10.1001/jamainternmed.2017.8667 | pmc=5876807 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29482218 }} </ref><ref name="pmid29641819">{{cite journal| author=O'Donnell AE, Schaefer KG, Stevenson LW, DeVoe K, Walsh K, Mehra MR | display-authors=etal| title=Social Worker-Aided Palliative Care Intervention in High-risk Patients With Heart Failure (SWAP-HF): A Pilot Randomized Clinical Trial. | journal=JAMA Cardiol | year= 2018 | volume= 3 | issue= 6 | pages= 516-519 | pmid=29641819 | doi=10.1001/jamacardio.2018.0589 | pmc=6128511 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29641819 }} </ref>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R]])'' <nowiki>"</nowiki> | ||
|- | |||
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''4.'''For patients with HF, execution of advance care directives can be useful to improve documentation of treatment preferences , delivery of patient-centered care, and dyingin preferred place.<ref name="pmid31720968">{{cite journal| author=Schichtel M, Wee B, Perera R, Onakpoya I| title=The Effect of Advance Care Planning on Heart Failure: a Systematic Review and Meta-analysis. | journal=J Gen Intern Med | year= 2020 | volume= 35 | issue= 3 | pages= 874-884 | pmid=31720968 | doi=10.1007/s11606-019-05482-w | pmc=7080664 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31720968 }} </ref>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki> | |||
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''4.'''In patients with advanced HF with expected survival <6 months, timely referral to hospice can be useful to improve QOL.<ref name="pmid20846650">{{cite journal| author=Candy B, Holman A, Leurent B, Davis S, Jones L| title=Hospice care delivered at home, in nursing homes and in dedicated hospice facilities: A systematic review of quantitative and qualitative evidence. | journal=Int J Nurs Stud | year= 2011 | volume= 48 | issue= 1 | pages= 121-33 | pmid=20846650 | doi=10.1016/j.ijnurstu.2010.08.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20846650 }} </ref>''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C-LD]])'' <nowiki>"</nowiki> | |||
|} | |} | ||
Revision as of 22:24, 15 June 2022
 |
Resident Survival Guide |
| File:Critical Pathways.gif |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Edzel Lorraine Co, D.M.D., M.D. [2]
Overview
End of life care in the patient with congestive heart failure is focused on making the patient comfortable. Invasive procedures should be minimized, and patients may elect to have their defibrillators inactivated. The growing number of patients with Stage IV heart failure (intractable symptoms of fatigue, shortness of breath or chest pain at rest despite optimal medical therapy) should be considered for palliative care or hospice, according to American College of Cardiology/American Heart Association guidelines listed below.
Some have argued that any patient with NYHA class III CHF should have a palliative care referral. Palliative care can not only provide symptom management, but also assist with advanced care planning, goals of care in the case of a significant decline, and making sure the patient has a medical power of attorney and discussed his or her wishes with this individual.
2022 AHA/ACC/HFSA Guideline/ 2013 ACCF/AHA Guideline/2009 ACC/AHA Focused Update and 2005 Guidelines for the Diagnosis and Management of Heart Failure in the Adult (DO NOT EDIT) [1] [2][3]
| Class I |
| "1.For all patients with HF, palliative and supportive care- including high-quality communication, conveyance of prognosis, clarifying goals of care, shared decision-making, symptom management, and caregiver support- should be provided to improve QOL and relieve suffering. [4](Level of Evidence: C-LD) " |
| "2. For patients with HF being considered for, or treated with, life-extending therapies, the option for discontinuation should be anticipated and discussed through the continuum of care, including at the time of initiation, and reassessed with changing medical conditions and shifting goals of care.[5][6] (Level of Evidence: C-LD) " |
| Class IIa | |
| "3.For patients with HF- particularly stage D HF patients being evaluated for advanced therapies, patients requiring inotropic support or temporary mechanical support, patients experiencing uncontrolled symptoms, major medical decisions, or multimorbidity, frailty, and cognitive impairment - specialist palliative care consultation can be useful to improve QOL and relieve suffering. [7][8][9](Level of Evidence: B-R) " | |
| "4.For patients with HF, execution of advance care directives can be useful to improve documentation of treatment preferences , delivery of patient-centered care, and dyingin preferred place.[10](Level of Evidence: C-LD) " | "4.In patients with advanced HF with expected survival <6 months, timely referral to hospice can be useful to improve QOL.[11](Level of Evidence: C-LD) " |
Vote on and Suggest Revisions to the Current Guidelines
External Links
- 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[12]
- 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation [3]
- The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult [13]
References
- ↑ 1.0 1.1 Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM; et al. (2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e876–e894. doi:10.1161/CIR.0000000000001062. PMID 35363500 Check
|pmid=value (help). - ↑ 2.0 2.1 2.2 Yancy CW, Jessup M, Bozkurt B, Masoudi FA, Butler J, McBride PE; et al. (2013). "2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. doi:10.1016/j.jacc.2013.05.019. PMID 23747642.
- ↑ 3.0 3.1 3.2 Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 119 (14):1977-2016.DOI:10.1161/CIRCULATIONAHA.109.192064 PMID:19324967
- ↑ Datla S, Verberkt CA, Hoye A, Janssen DJA, Johnson MJ (2019). "Multi-disciplinary palliative care is effective in people with symptomatic heart failure: A systematic review and narrative synthesis". Palliat Med. 33 (8): 1003–1016. doi:10.1177/0269216319859148. PMID 31307276.
- ↑ Goldstein N, Carlson M, Livote E, Kutner JS (2010). "Brief communication: Management of implantable cardioverter-defibrillators in hospice: A nationwide survey". Ann Intern Med. 152 (5): 296–9. doi:10.7326/0003-4819-152-5-201003020-00007. PMC 2832227. PMID 20194235.
- ↑ McIlvennan CK, Jones J, Allen LA, Swetz KM, Nowels C, Matlock DD (2016). "Bereaved Caregiver Perspectives on the End-of-Life Experience of Patients With a Left Ventricular Assist Device". JAMA Intern Med. 176 (4): 534–9. doi:10.1001/jamainternmed.2015.8528. PMID 26998594.
- ↑ Rogers JG, Patel CB, Mentz RJ, Granger BB, Steinhauser KE, Fiuzat M; et al. (2017). "Palliative Care in Heart Failure: The PAL-HF Randomized, Controlled Clinical Trial". J Am Coll Cardiol. 70 (3): 331–341. doi:10.1016/j.jacc.2017.05.030. PMC 5664956. PMID 28705314.
- ↑ Bekelman DB, Allen LA, McBryde CF, Hattler B, Fairclough DL, Havranek EP; et al. (2018). "Effect of a Collaborative Care Intervention vs Usual Care on Health Status of Patients With Chronic Heart Failure: The CASA Randomized Clinical Trial". JAMA Intern Med. 178 (4): 511–519. doi:10.1001/jamainternmed.2017.8667. PMC 5876807. PMID 29482218.
- ↑ O'Donnell AE, Schaefer KG, Stevenson LW, DeVoe K, Walsh K, Mehra MR; et al. (2018). "Social Worker-Aided Palliative Care Intervention in High-risk Patients With Heart Failure (SWAP-HF): A Pilot Randomized Clinical Trial". JAMA Cardiol. 3 (6): 516–519. doi:10.1001/jamacardio.2018.0589. PMC 6128511. PMID 29641819.
- ↑ Schichtel M, Wee B, Perera R, Onakpoya I (2020). "The Effect of Advance Care Planning on Heart Failure: a Systematic Review and Meta-analysis". J Gen Intern Med. 35 (3): 874–884. doi:10.1007/s11606-019-05482-w. PMC 7080664 Check
|pmc=value (help). PMID 31720968. - ↑ Candy B, Holman A, Leurent B, Davis S, Jones L (2011). "Hospice care delivered at home, in nursing homes and in dedicated hospice facilities: A systematic review of quantitative and qualitative evidence". Int J Nurs Stud. 48 (1): 121–33. doi:10.1016/j.ijnurstu.2010.08.003. PMID 20846650.
- ↑ Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW (May 2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e895–e1032. doi:10.1161/CIR.0000000000001063. PMID 35363499 Check
|pmid=value (help). - ↑ Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG et al. (2005) ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 112 (12):e154-235. DOI:10.1161/CIRCULATIONAHA.105.167586 PMID: 16160202