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Special Article |

Integrating Palliative Care Into Heart Failure Care

Paul J. Hauptman, MD; Edward P. Havranek, MD
Arch Intern Med. 2005;165(4):374-378. doi:10.1001/archinte.165.4.374.
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Heart failure is a condition for which both palliative care and hospice care can be appropriate. The disease’s increasing prevalence and predilection for elderly patients with significant comorbidity underscore the need to integrate these modes of care with the acute care approach that has dominated heart failure treatment. We propose integration of a palliative care approach early in the course of heart failure treatment and a tiered process for selecting patients for hospice care. A transition of the focus to palliative care rather than mortality reduction should occur over time, when clinical status deteriorates and advanced therapeutic options become inappropriate or ineffective. Failure to respond to the need for palliative care puts at risk the mandate to treat the patient with heart failure during the entire course of illness.

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Figure.

Algorithm for integrating palliative care into the care of patients with advanced heart failure. ICD indicates implantable cardiodefibrillator; LV, left ventricular; LVF, LV function.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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