TY - JOUR

T1 - The First Steps Taken to Implement Palliative Care in Advanced Heart Disease

T2 - A Position Statement from Denmark

AU - Hansen, Vibeke Brogaard

AU - Aagaard, Susanne

AU - Hygum, Anette

AU - Johansen, Jens Brock

AU - Pedersen, Susanne S.

AU - Nielsen, Vivi Lindeborg

AU - Neergaard, Mette Asbjørn

AU - Salomonsen, Gitte Ryom

AU - Guldin, Mai Britt

AU - Gustafsson, Ida

AU - Eiskjær, Hans

AU - Gustafsson, Finn

AU - Roikjær, Stine Gundtoft

AU - Nørager, Betina

AU - Larsen, Henrik

AU - Zwisler, Ann Dorthe

PY - 2020

Y1 - 2020

N2 - According to the World Health Organization, palliative care must be available for everyone with life-threatening diseases. However, in daily practice the primary focus worldwide is on cancer patients. The aim of the article was to generate a national position statement as the first step in implementing palliative care in severe heart disease with focus on advanced heart failure, including tools to identify the need for and timing of palliative care and how palliative care could be organized in Denmark. A task force was formed in the Danish Society of Cardiology Heart Failure Working Group, and the position statement was prepared in collaboration with members from a broad group of specialties, including palliative medicine. Because of major gaps in evidence, the position statement was based on small and low-quality studies and clinical practice statements. This position statement was aligned with the European Society of Cardiology recommendation, focusing on relieving suffering from the early disease stages parallel to standard care and supplementing life-prolonging treatment. The statement delivers practical guidance on clinical aspects and managing symptoms during the three stages of advanced heart disease. Furthermore, the statement describes the importance of communication and topics to be broached, including deactivating implantable cardioverter defibrillators. The statement recommends a targeted effort on organizational strategies using high-quality assessment tools and emphasizes multidisciplinary and intersectoral collaboration. Danish cardiologists supported by allied professionals acknowledge the importance of palliative care in advanced heart disease. This national position statement intended to inform and influence policy and practice and can hopefully inspire other countries to take action toward implementing palliative care in advanced heart disease.

AB - According to the World Health Organization, palliative care must be available for everyone with life-threatening diseases. However, in daily practice the primary focus worldwide is on cancer patients. The aim of the article was to generate a national position statement as the first step in implementing palliative care in severe heart disease with focus on advanced heart failure, including tools to identify the need for and timing of palliative care and how palliative care could be organized in Denmark. A task force was formed in the Danish Society of Cardiology Heart Failure Working Group, and the position statement was prepared in collaboration with members from a broad group of specialties, including palliative medicine. Because of major gaps in evidence, the position statement was based on small and low-quality studies and clinical practice statements. This position statement was aligned with the European Society of Cardiology recommendation, focusing on relieving suffering from the early disease stages parallel to standard care and supplementing life-prolonging treatment. The statement delivers practical guidance on clinical aspects and managing symptoms during the three stages of advanced heart disease. Furthermore, the statement describes the importance of communication and topics to be broached, including deactivating implantable cardioverter defibrillators. The statement recommends a targeted effort on organizational strategies using high-quality assessment tools and emphasizes multidisciplinary and intersectoral collaboration. Danish cardiologists supported by allied professionals acknowledge the importance of palliative care in advanced heart disease. This national position statement intended to inform and influence policy and practice and can hopefully inspire other countries to take action toward implementing palliative care in advanced heart disease.

KW - advanced heart disease

KW - end-of-life

KW - intersectoral

KW - multidisciplinary

KW - palliative care

U2 - 10.1089/jpm.2019.0566

DO - 10.1089/jpm.2019.0566

M3 - Journal article

C2 - 32380928

AN - SCOPUS:85090274147

VL - 23

SP - 1159

EP - 1166

JO - Journal of Palliative Medicine

JF - Journal of Palliative Medicine

SN - 1096-6218

IS - 9

ER -