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European Journal of Heart Failure Advance Access originally published online on February 5, 2009
European Journal of Heart Failure 2009 11(4):406-412; doi:10.1093/eurjhf/hfp007
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

A comparative study of the palliative care needs of heart failure and cancer patients

Norma O'Leary1,{dagger},*, Niamh F. Murphy2, Christina O'Loughlin2, Eoin Tiernan1 and Kenneth McDonald2

1 Department of Palliative Medicine, St Vincent's University Hospital, Dublin, Ireland
2 Department of Cardiology, St Vincent's University Hospital, Dublin, Ireland

* Corresponding author. Tel: +353 87 6328876, Fax: +353 1 2094533, Email: normaoleary{at}hotmail.com


  Abstract

Aims: Studies suggest that patients with advanced heart failure (HF) have unmet palliative care (PC) needs. However, many of these studies have been retrospective or based on patients receiving poorly coordinated ad hoc care. We aimed to demonstrate whether the PC needs of patients with advanced HF receiving specialist multidisciplinary coordinated care are similar to cancer patients deemed to have specialist PC needs; thereby justifying the extension of specialist PC services to HF patients.

Methods and results: This was a cross-sectional comparative cohort study of 50 HF patients and 50 cancer patients, using quantitative and qualitative methods. Both patient cohorts were statistically indistinguishable in terms of symptom burden, emotional wellbeing, and quality-of-life scores. HF patients had good access to community and social support. HF patients particularly valued the close supervision, medication monitoring, ease of access to service, telephone support, and key worker provided at the HF unit. A small subset of patients had unmet PC needs. A palliative transition point is described.

Conclusion: HF patients should not be excluded from specialist PC services. However, the majority of their needs can be met at a HF unit. Recognition of the palliative transition point may be key to ensuring that end-of-life issues are addressed. The palliative transition point needs further evaluation.

Key Words: Heart failure • Cancer • Palliative care • End of life • Communication • Patient preferences

Received June 30, 2008; Revised November 14, 2008; Accepted November 28, 2008

{dagger} Present address: Consultant in Palliative Medicine, Gateshead Health NHS Foundation Trust and Marie Curie Hospice, Newcastle upon Tyne, UK.


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