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

Publication ,  Journal Article
Kavalieratos, D; Kamal, AH; Abernethy, AP; Biddle, AK; Carey, TS; Dev, S; Reeve, BB; Weinberger, M
Published in: J Palliat Med
April 2014

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.

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Published In

J Palliat Med

DOI

EISSN

1557-7740

Publication Date

April 2014

Volume

17

Issue

4

Start / End Page

475 / 481

Location

United States

Related Subject Headings

  • Quality of Life
  • Palliative Care
  • North Carolina
  • Neoplasms
  • Middle Aged
  • Male
  • Humans
  • Hospitals, Community
  • Heart Failure
  • Health Services Needs and Demand
 

Citation

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Kavalieratos, D., Kamal, A. H., Abernethy, A. P., Biddle, A. K., Carey, T. S., Dev, S., … Weinberger, M. (2014). Comparing unmet needs between community-based palliative care patients with heart failure and patients with cancer. J Palliat Med, 17(4), 475–481. https://doi.org/10.1089/jpm.2013.0526
Kavalieratos, Dio, Arif H. Kamal, Amy P. Abernethy, Andrea K. Biddle, Timothy S. Carey, Sandesh Dev, Bryce B. Reeve, and Morris Weinberger. “Comparing unmet needs between community-based palliative care patients with heart failure and patients with cancer.J Palliat Med 17, no. 4 (April 2014): 475–81. https://doi.org/10.1089/jpm.2013.0526.
Kavalieratos D, Kamal AH, Abernethy AP, Biddle AK, Carey TS, Dev S, et al. Comparing unmet needs between community-based palliative care patients with heart failure and patients with cancer. J Palliat Med. 2014 Apr;17(4):475–81.
Kavalieratos, Dio, et al. “Comparing unmet needs between community-based palliative care patients with heart failure and patients with cancer.J Palliat Med, vol. 17, no. 4, Apr. 2014, pp. 475–81. Pubmed, doi:10.1089/jpm.2013.0526.
Kavalieratos D, Kamal AH, Abernethy AP, Biddle AK, Carey TS, Dev S, Reeve BB, Weinberger M. Comparing unmet needs between community-based palliative care patients with heart failure and patients with cancer. J Palliat Med. 2014 Apr;17(4):475–481.
Journal cover image

Published In

J Palliat Med

DOI

EISSN

1557-7740

Publication Date

April 2014

Volume

17

Issue

4

Start / End Page

475 / 481

Location

United States

Related Subject Headings

  • Quality of Life
  • Palliative Care
  • North Carolina
  • Neoplasms
  • Middle Aged
  • Male
  • Humans
  • Hospitals, Community
  • Heart Failure
  • Health Services Needs and Demand