Study reveals low rates of palliative care for heart failure patients in the U.S.
· News-MedicalA study by researchers at Saint Louis University shows that only one in eight patients with heart failure in the United States receive palliative care consultations within five years of diagnosis.
Zidong Zhang, Ph.D., research scientist at the AHEAD Institute at SLU's School of Medicine, the paper's senior and corresponding authorHowever, anecdotal reports suggest that most patients with heart failure do not receive palliative care, and those who do typically receive it only in the last two to three weeks of life."
"To our knowledge, this is the first study to investigate the uptake of palliative care consultation following a heart failure diagnosis in the general U.S. population. Unlike the previous studies focusing on Medicare beneficiaries or veterans, our research provides a more general insight into early palliative care integration for heart failure across the entire nation," he explained.
Zhang and his co-authors found that patients who did not have cardiogenic shock, a life-threatening condition in which your heart suddenly can't pump enough blood to meet your body's needs, but received inotropic therapy, drugs that tell your heart muscles to beat or contract with more power or less power, were less likely to have palliative care consultations. However, among patients treated for cardiogenic shock with advanced therapies, the likelihood of receiving palliative care almost tripled. Zhang and his co-authors attributed this discrepancy to the intended purpose of treatment and clinical inertia in managing complex cases.
"These might include removing barriers in the payment system for concurrent care, assisting physicians in determining when to initiate the palliative care conversation with patients, and, in a health system, expanding outpatient and community-based palliative care service and streamlining the referral and transition of palliative care from cardiac care to inpatient service to community," he said.
Other authors include Divya S. Subramaniam, Ph.D., of Department of Health and Clinical Outcomes and the AHEAD Institute, Saint Louis University School of Medicine; Steven W. Howard, Ph.D., of University of Alabama at Birmingham; Kenton J. Johnston, Ph.D., of Department of Internal Medicine, Washington University School of Medicine; William H. Frick, M.D., of Department of Internal Medicine, Saint Louis University School of Medicine; Kimberly Enard, Ph.D., of College for Public Health and Social Justice, Saint Louis University; and Leslie Hinyard, Ph.D., of Department of Health and Clinical Outcomes and the AHEAD Institute, Saint Louis University School of Medicine.
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