Comparing unmet needs between community-based palliative care patients with heart failure and patients with cancer.

Journal Article (Journal Article)

BACKGROUND: As the role of palliative care (PC) has yet to be clearly defined in patients with heart failure (HF), such patients may face barriers regarding PC referral. In order to maximally meet the needs of HF patients, it is necessary to understand how they compare to the classic PC population: patients with cancer. OBJECTIVE: To characterize the unresolved symptom and treatment needs with which patients with HF and those with cancer present to PC. METHODS: We used data from the Palliative Care Research Registry (PCRR), a repository of quality improvement data from three community-based PC organizations. We abstracted first PC visit data from the PCRR for patients with primary diagnoses of HF or cancer seen between 2008 and 2012. We assessed the association of primary diagnosis (i.e., HF or cancer) on three outcomes: unresolved symptoms, treatment gaps, and a composite indicator of symptom control and quality of life. Analyses included descriptive statistics and multivariate Poisson regression. RESULTS: Our analytic sample comprised 334 patients with HF and 697 patients with cancer, the majority of whom were white and male. Compared to patients with cancer, patients with HF presented with fewer unresolved symptoms, both overall and at moderate/severe distress levels. Patients with HF more commonly reported moderately/severely distressful dyspnea (25% versus 18%, p=0.02), and more commonly experienced dyspnea-related treatment gaps (17% versus 8%, p<0.001). CONCLUSIONS: Patients with HF possess care needs that are squarely within the purview of PC. Future work is needed to delineate how PC referral policies should be refined to optimize PC access for patients with HF.

Full Text

Duke Authors

Cited Authors

  • Kavalieratos, D; Kamal, AH; Abernethy, AP; Biddle, AK; Carey, TS; Dev, S; Reeve, BB; Weinberger, M

Published Date

  • April 2014

Published In

Volume / Issue

  • 17 / 4

Start / End Page

  • 475 - 481

PubMed ID

  • 24588568

Pubmed Central ID

  • PMC3991968

Electronic International Standard Serial Number (EISSN)

  • 1557-7740

Digital Object Identifier (DOI)

  • 10.1089/jpm.2013.0526


  • eng

Conference Location

  • United States