Heart Failure Patients Urged to Discuss Care With Docs

MONDAY March 5, 2012 -- Patients suffering from advanced heart failure should maintain an open dialogue with their physicians, so everyone is on the same page with patients' long-range personal wishes regarding treatment, experts say.

The advice is outlined in a "scientific statement" published March 5 in the journal Circulation.

"For patients with advanced heart failure, the decision-making process should be proactive, anticipatory and patient-centered," lead author Dr. Larry Allen, an assistant professor of medicine at the University of Colorado Anschutz Medical Center, said in a journal news release. "This involves talking about goals of care, expectations for the future, and the full range of treatment options, including palliative care." Palliative care involves pain relief in the absence of a cure.

According to the release, about 3 percent of American adults have heart failure, a figure that goes up with age. The condition develops when the heart can no longer pump enough blood, resulting in fatigue, shortness of breath and ankle swelling. Heart failure often progressively worsens.

Allen and colleagues stressed the importance of building a patient-doctor consensus with respect to questions of survival, symptom relief and quality of life issues. Depending on their personal perspective and situation, not all patients want to "do everything" at all costs, they noted.

One way to promote such a discussion, the authors said, is to set aside one day a year to review the patient's situation, focusing on prognosis and possible treatments alongside an appreciation for the patient's values and goals.

Such an annual review, however, should not replace appropriate discussions at critical junctures in a patient's ongoing care, such as when a turn for the worse or hospitalization occurs.

"The process of checking in with patients on a regular basis is extremely important because heart failure and general health change over time," Allen said.

More information

For more on heart failure, visit the U.S. National Library of Medicine.

Posted: March 2012


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