International Journal of Cardiology
Volume 125, Issue 2 , Pages 183-190 , 10 April 2008

Defining the role of palliative care in older adults with heart failure

  • David B. Bekelman

      Affiliations

    • Department of Medicine, University of Colorado at Denver and Health Sciences Center, USA
    • Corresponding Author InformationCorresponding author. Division of General Internal Medicine, 12631 East 17th Avenue, B180, Aurora, Colorado 80045, USA. Tel.: +1 303 724 2245; fax: +1 303 724 2270.
    • ,
  • Evelyn Hutt

      Affiliations

    • Department of Medicine, University of Colorado at Denver and Health Sciences Center, USA
    • Department of Veterans Affairs Medical Center, Eastern Colorado Health Care System, USA
    • ,
  • Frederick A. Masoudi

      Affiliations

    • Department of Medicine, University of Colorado at Denver and Health Sciences Center, USA
    • Department of Medicine, Denver Health Medical Center, USA
    • ,
  • Jean S. Kutner

      Affiliations

    • Department of Medicine, University of Colorado at Denver and Health Sciences Center, USA
    • ,
  • John S. Rumsfeld

      Affiliations

    • Department of Medicine, University of Colorado at Denver and Health Sciences Center, USA
    • Department of Veterans Affairs Medical Center, Eastern Colorado Health Care System, USA

References 

  1. Masoudi FA, Havranek EP, Krumholz HM. The burden of chronic congestive heart failure in older persons: magnitude and implications for policy and research. Heart Fail Rev. 2002;7(1):9–16
  2. McMurray JJ, Pfeffer MA. Heart failure. Lancet. 2005;365(9474):1877–1889
  3. McMurray JJ, Stewart S. Epidemiology, aetiology, and prognosis of heart failure. Heart. 2000;83(5):596–602
  4. Kosiborod M, Lichtman JH, Heidenreich PA, et al. National trends in outcomes among elderly patients with heart failure. Am J Med. 2006;119(7):616–617
  5. Masoudi FA, Havranek EP, Wolfe P, et al. Most hospitalized older persons do not meet the enrollment criteria for clinical trials in heart failure. Am Heart J. 2003;146(2):250–257
  6. Havranek EP, Masoudi FA, Westfall KA, Wolfe P, Ordin DL, Krumholz HM. Spectrum of heart failure in older patients: results from the National Heart Failure project. Am Heart J. 2002;143(3):412–417
  7. Masoudi FA, Baillie CA, Wang Y, et al. The complexity and cost of drug regimens of older patients hospitalized with heart failure in the United States, 1998–2001. Arch Intern Med. 2005;165(18):2069–2076
  8. Juenger J, Schellberg D, Kraemer S, et al. Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables. Heart. 2002;87(3):235–241
  9. Steptoe A, Mohabir A, Mahon NG, McKenna WJ. Health related quality of life and psychological wellbeing in patients with dilated cardiomyopathy. Heart. 2000;83(6):645–650
  10. Johansson P, Agnebrink M, Dahlstrom U, Brostrom A. Measurement of health-related quality of life in chronic heart failure, from a nursing perspective — a review of the literature. Eur J Cardiovasc Nurs. 2004;3(1):7–20
  11. Stewart AL, Greenfield S, Hays RD, et al. Functional status and well-being of patients with chronic conditions. Results from the Medical Outcomes Study. JAMA. 1989;262(7):907–913
  12. Stanek EJ, Oates MB, McGhan WF, Denofrio D, Loh E. Preferences for treatment outcomes in patients with heart failure: symptoms versus survival. J Card Fail. 2000;6(3):225–232
  13. Konstam V, Salem D, Pouleur H, et al. Baseline quality of life as a predictor of mortality and hospitalization in 5025 patients with congestive heart failure. SOLVD Investigations. Studies of Left Ventricular Dysfunction Investigators. Am J Cardiol. 1996;78(8):890–895
  14. Soto GE, Jones P, Weintraub WS, Krumholz HM, Spertus JA. Prognostic value of health status in patients with heart failure after acute myocardial infarction. Circulation. 2004;110(5):546–551
  15. Heidenreich PA, Spertus JA, Jones PG, et al. Health status identifies heart failure outpatients at risk for hospitalization or death. J Am Coll Cardiol. 2006;47(4):752–756
  16. Heo S, Moser DK, Riegel B, Hall LA, Christman N. Testing a published model of health-related quality of life in heart failure. J Card Fail. 2005;11(5):372–379
  17. Zambroski CH, Moser DK, Bhat G, Ziegler C. Impact of symptom prevalence and symptom burden on quality of life in patients with heart failure. Eur J Cardiovasc Nurs. 2005;4(3):198–206
  18. Bekelman DB, Havranek EP, Becker DM, et al. Symptoms, depression, and quality of life in patients with heart failure. J Card Fail 2007;13(8)(Oct):643–8.
  19. Bristow MR, Saxon LA, Boehmer J, et al. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med. 2004;350(21):2140–2150
  20. Cleland JG, Daubert JC, Erdmann E, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005;352(15):1539–1549
  21. Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ. Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. J Am Coll Cardiol. 2006;48(8):1527–1537
  22. Rumsfeld JS, Havranek E, Masoudi FA, et al. Depressive symptoms are the strongest predictors of short-term declines in health status in patients with heart failure. J Am Coll Cardiol. 2003;42(10):1811–1817
  23. Jiang W, Alexander J, Christopher E, et al. Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure. Arch Intern Med. 2001;161(15):1849–1856
  24. Sullivan M, Simon G, Spertus J, Russo J. Depression-related costs in heart failure care. Arch Intern Med. 2002;162(16):1860–1866
  25. Dunbar SB, Kimble LP, Jenkins LS, et al. Association of mood disturbance and arrhythmia events in patients after cardioverter defibrillator implantation. Depress Anxiety. 1999;9(4):163–168
  26. Tranmer JE, Heyland D, Dudgeon D, Groll D, Squires-Graham M, Coulson K. Measuring the symptom experience of seriously ill cancer and noncancer hospitalized patients near the end of life with the memorial symptom assessment scale. J Pain Symptom Manage. 2003;25(5):420–429
  27. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–613
  28. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–370
  29. Arthur A, Jagger C, Lindesay J, Graham C, Clarke M. Using an annual over-75 health check to screen for depression: validation of the short Geriatric Depression Scale (GDS15) within general practice. Int J Geriatr Psychiatry. 1999;14(6):431–439
  30. MacIntyre K, Capewell S, Stewart S, et al. Evidence of improving prognosis in heart failure: trends in case fatality in 66547 patients hospitalized between 1986 and 1995. Circulation. 2000;102(10):1126–1131
  31. Stewart S, MacIntyre K, Hole DJ, Capewell S, McMurray JJ. More ‘malignant’ than cancer? Five-year survival following a first admission for heart failure. Eur J Heart Fail. 2001;3(3):315–322
  32. Lunney JR, Lynn J, Foley DJ, Lipson S, Guralnik JM. Patterns of functional decline at the end of life. JAMA. 2003;289(18):2387–2392
  33. Murray SA, Boyd K, Kendall M, Worth A, Benton TF, Clausen H. Dying of lung cancer or cardiac failure: prospective qualitative interview study of patients and their carers in the community. BMJ. 2002;325(7370):929
  34. Horne G, Payne S. Removing the boundaries: palliative care for patients with heart failure. Palliat Med. 2004;18(4):291–296
  35. Murray SA, Kendall M, Boyd K, Worth A, Benton TF. Exploring the spiritual needs of people dying of lung cancer or heart failure: a prospective qualitative interview study of patients and their carers. Palliat Med. 2004;18(1):39–45
  36. Rogers AE, Addington-Hall JM, Abery AJ, et al. Knowledge and communication difficulties for patients with chronic heart failure: qualitative study. BMJ. 2000;321(7261):605–607
  37. Goldstein NE, Lampert R, Bradley E, Lynn J, Krumholz HM. Management of implantable cardioverter defibrillators in end-of-life care. Ann Intern Med. 2004;141(11):835–838
  38. Dracup K, Evangelista LS, Doering L, Tullman D, Moser DK, Hamilton M. Emotional well-being in spouses of patients with advanced heart failure. Heart Lung. 2004;33(6):354–361
  39. Martensson J, Dracup K, Canary C, Fridlund B. Living with heart failure: depression and quality of life in patients and spouses. J Heart Lung Transplant. 2003;22(4):460–467
  40. Hooley PJ, Butler G, Howlett JG. The relationship of quality of life, depression, and caregiver burden in outpatients with congestive heart failure. Congest Heart Fail. 2005;11(6):303–310
  41. Evangelista LS, Dracup K, Doering L, Westlake C, Fonaro GC, Hamilton M. Emotional well-being of heart failure patients and their caregivers. J Card Fail. 2002;8(5):300–305
  42. Schulz R, Beach SR. Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. JAMA. 1999;282(23):2215–2219
  43. National Quality Forum . A national framework and preferred practices for palliative and hospice care quality. Washington, DC: NQF; 2007;
  44. National Consensus Project for Quality Palliative Care. Clinical practice guidelines for quality palliative care. http://www.nationalconsensusproject.org. 2004.
  45. Morrison RS, Meier DE. Clinical practice. Palliative care. N Engl J Med. 2004;350(25):2582–2590
  46. Higginson IJ, Finlay I, Goodwin DM, et al. Do hospital-based palliative teams improve care for patients or families at the end of life?. J Pain Symptom Manage. 2002;23(2):96–106
  47. Finlay IG, Higginson IJ, Goodwin DM, et al. Palliative care in hospital, hospice, at home: results from a systematic review. Ann Oncol. 2002;13(Suppl 4):257–264
  48. Rabow MW, Dibble SL, Pantilat SZ, McPhee SJ. The comprehensive care team: a controlled trial of outpatient palliative medicine consultation. Arch Intern Med. 2004;164(1):83–91
  49. Morrison RS, Maroney-Galin C, Kralovec PD, Meier DE. The growth of palliative care programs in United States hospitals. J Palliat Med. 2005;8(6):1127–1134
  50. Hauptman PJ, Havranek EP. Integrating palliative care into heart failure care. Arch Intern Med. 2005;165(4):374–378
  51. Goodlin SJ, Hauptman PJ, Arnold R, et al. Consensus statement: palliative and supportive care in advanced heart failure. J Card Fail. 2004;10(3):200–209
  52. Pantilat SZ, Steimle AE. Palliative care for patients with heart failure. JAMA. 2004;291(20):2476–2482
  53. Hunt SA, Abraham WT, Chin MH, et al. 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. 2005;112(12):e154–e235
  54. Addington-Hall JM, Gibbs JS. Heart failure now on the palliative care agenda. Palliat Med. 2000;14(5):361–362
  55. Athavale NV. Palliative care is an important aspect of heart failure management. Age Ageing. 2003;32(1):117–118
  56. Gibbs JS, McCoy AS, Gibbs LM, Rogers AE, Addington-Hall JM. Living with and dying from heart failure: the role of palliative care. Heart. 2002;88(Suppl 2):ii36–ii39
  57. Gottlieb SH. Palliative care in heart failure. Heart. 2003;3(8):326–335
  58. Lewis C, Stephens B. Improving palliative care provision for patients with heart failure. Br J Nurs. 2005;14(10):563–567
  59. Stewart S, McMurray JJ. Palliative care for heart failure. BMJ. 2002;325(7370):915–916
  60. Ward C. The need for palliative care in the management of heart failure. Heart. 2002;87(3):294–298
  61. Woodend AK. What's new in palliative care for patients with heart failure?. Can J Cardiovasc Nurs. 2005;15(2):3–4
  62. Oxford textbook of palliative medicine. 3rd ed. New York: Oxford University Press; 2004;
  63. Wilson KG, Chochinov HM, de Faye BJ, Breitbart W. Diagnosis and management of depression in palliative care. In:  Chochinov HM,  Breitbart W editor. Handbook of psychiatry in palliative medicine. New York: Oxford; 2000;p. 25–49
  64. Bekelman DB, Sullivan M. Depression and anxiety in patients with chronic heart failure. In: Beattie, J., Goodlin, S., editors. Supportive Care of the Cardiac Patient. Oxford: Oxford University Press, in press.
  65. Lesperance F, Frasure-Smith N, Koszycki D, et al. Effects of citalopram and interpersonal psychotherapy on depression in patients with coronary artery disease: the Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) trial. JAMA. 2007;297(4):367–379
  66. Coulehan JL, Platt FW, Egener B, et al. “Let me see if i have this right...”: words that help build empathy. Ann Intern Med. 2001;135(3):221–227
  67. Berkman LF, Blumenthal J, Burg M, et al. Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial. JAMA. 2003;289(23):3106–3116
  68. Gilbody S, Bower P, Fletcher J, Richards D, Sutton AJ. Collaborative care for depression: a cumulative meta-analysis and review of longer-term outcomes. Arch Intern Med. 2006;166(21):2314–2321
  69. Bekelman DB, Dy SM, Becker DM, et al. Spiritual well-being and depression in patients with heart failure. J Gen Intern Med. 2007;22(4):470–477
  70. Selman L, Harding R, Beynon T, et al. Improving end of life care for chronic heart failure patients — “Let's hope it'll get better, when I know in my heart of hearts it won't”. Heart. 2007;93(8):963–967
  71. Tulsky JA. Doctor–patient communication. In:  Morrison RS,  Meier DE editor. Geriatric palliative care. New York: Oxford University Press; 2003;p. 314–331
  72. The EPEC Project: Education on Palliative and End-of-life Care. http://www.epec.net. 2003.
  73. Buckman R. How to break bad news: a guide for health professionals. Baltimore, MD: Johns Hopkins Unviersity Press; 1992;
  74. Williams SG, Wright DJ, Marshall P, et al. Safety and potential benefits of low dose diamorphine during exercise in patients with chronic heart failure. Heart. 2003;89(9):1085–1086
  75. Johnson MJ, McDonagh TA, Harkness A, McKay SE, Dargie HJ. Morphine for the relief of breathlessness in patients with chronic heart failure — a pilot study. Eur J Heart Fail. 2002;4(6):753–756
  76. Weiner JS, Arnold RM, Curtis JR, Back AL, Rounsaville B, Tulsky JA. Manualized communication interventions to enhance palliative care research and training: rigorous, testable approaches. J Palliat Med. 2006;9(2):371–381
  77. Johnson MJ, Houghton T. Palliative care for patients with heart failure: description of a service. Palliat Med. 2006;20(3):211–214

PII: S0167-5273(07)01620-8

doi: 10.1016/j.ijcard.2007.10.005

International Journal of Cardiology
Volume 125, Issue 2 , Pages 183-190 , 10 April 2008

Article Tools

* Image Usage & Resolution