Palliative Care for Patients With Heart Failure: An Integrative Review.
Changhwan Kim, Sanghee Kim, Kyunghwa Lee and 2 others
PMID 35358113WHAT IT FOUND
Multidisciplinary palliative care for heart failure often improved quality of life and symptoms.
Hospital readmission, mortality, hospice use, and do-not-resuscitate orders were less consistent.
Key findings
01Most included studies reported statistically significant improvement in quality of life after palliative care intervention.
02Symptom burden decreased significantly in two of the three studies that measured it, and depression or anxiety improved in the three studies that evaluated them.
03Hospital readmission decreased significantly in two of five studies, mortality decreased in one of three, and palliative care service use and do-not-resuscitate orders showed no significant change.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only six randomized trials were included, and the trials enrolled between 72 and 384 participants. Many trials had unclear or high risk of bias, especially for blinding participants and personnel. Interventions were multidisciplinary bundles, so the effect of any single component cannot be separated. Most studies were from Western countries. The review did not compare intervention contents, dose, or measures. The included studies did not use patient-reported outcome measures as selection criteria for palliative care, except one.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that palliative care for heart failure clearly reduces hospital readmission or mortality. Hospital readmission decreased in only two of five studies, mortality decreased in only one of three, and palliative care service use and do-not-resuscitate orders showed no significant change.