Authors recommend patient and physician education and changes to practice guidelines and payment to overcome barriers to palliative care use
By Lori Solomon HealthDay Reporter
WEDNESDAY, Nov. 13, 2024 (HealthDay News) — Use of palliative care for heart failure remains low in the United States, according to a study recently published online in the Journal of the American Heart Association.
Zidong Zhang, Ph.D., from the Saint Louis University School of Medicine, and colleagues investigated national palliative care use for adults with heart failure. A national all‐payer electronic health record database was used to identify 127,712 adults with newly diagnosed heart failure (2011 to 2018) and to determine when they received their first palliative care consultation and the associations with clinical factors following diagnosis of heart failure.
During a median 792 days of follow-up, 18.3 percent of patients received palliative care consultation in five years. The researchers found that shorter time to receive palliative care consultation was associated with diagnoses of heart failure in 2016 to 2018 (compared with 2010 to 2015: adjusted hazard ratio [aHR], 1.421), as well as advanced heart failure diagnosis (aHR, 2.065), cardiogenic shock (aHR, 2.587), implantable cardioverter‐defibrillator use (aHR, 5.718), and visits at academic medical centers (aHR, 1.439). There was variance in palliative care uptake for early/moderate heart failure stages by race, geographics, payer, and selection of advanced treatments.
“Barriers to palliative care should [be] addressed at a systemic level, including educating patients and providers on the role and benefits of palliative care consultation, expanding the palliative care service availability, making consensus practice guidelines, and reforming the payment method,” the authors write.
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