Criteria for Referral of Patients With Advanced Heart Failure for Specialized Palliative Care

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dc.contributor.authorChang, Yuchieh Kathryn
dc.contributor.authorAllen, Larry A.
dc.contributor.authorMcClung, John A.
dc.contributor.authorDenvir, Martin A.
dc.contributor.authorPhilip, Jennifer
dc.contributor.authorMori, Masanori
dc.contributor.authorPerez-Cruz, Pedro
dc.contributor.authorCheng, Shao-Yi
dc.contributor.authorCollins, Anna
dc.contributor.authorHui, David
dc.date.accessioned2025-01-20T21:02:07Z
dc.date.available2025-01-20T21:02:07Z
dc.date.issued2022
dc.description.abstractBACKGROUND Patients with advanced heart failure have substantial supportive care needs. Specialist palliative care can be beneficial, but it is unclear who is most appropriate for referral and when patients should be referred.
dc.description.abstractOBJECTIVES We conducted a Delphi study of international experts to identify consensus referral criteria for specialist palliative care for patients with advanced heart failure.
dc.description.abstractMETHODS Clinicians from 5 continents with expertise in the integration of cardiology and palliative care were asked to rate 34 disease-based, 24 needs-based, and 9 time-based criteria over 3 rounds. Consensus was defined a priori as >= 70% agreement. A criterion was coded as major if the experts endorsed that meeting that criterion alone was adequate to justify a referral.
dc.description.abstractRESULTS The response rate was 44 of 46 (96%), 41 of 46 (89%), and 43 of 46 (93%) in the first, second, and third rounds, respectively. Panelists reached consensus on 25 major criteria for specialist palliative care referral. The 25 major criteria were categorized under 6 topics, including "advanced/refractory heart failure, comorbidities, and complications" (eg, cardiac cachexia, cardiorenal syndrome) (n = 8), "advanced heart failure therapies" (eg, chronic inotropes, precardiac transplant) (n = 4), "hospital utilization" (eg, emergency room visits, hospitalization) (n = 2), "prognostic estimate" (n = 1), "symptom burden/distress" (eg, severe physical/emotional/spiritual distress) (n = 6), and "decision making/social support" (eg, goals-of-care discussions) (n = 4). The majority (68%) of major criteria had >= 90% agreement.
dc.description.abstractCONCLUSIONS International experts reached consensus on a large number of criteria for referral to specialist palliative care. With further validation, these criteria may be useful for standardizing palliative care access in the inpatient and/or outpatient settings. (C) 2022 by the American College of Cardiology Foundation.
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.jacc.2022.04.057
dc.identifier.eissn1558-3597
dc.identifier.issn0735-1097
dc.identifier.urihttps://doi.org/10.1016/j.jacc.2022.04.057
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/93017
dc.identifier.wosidWOS:000861831600007
dc.issue.numero4
dc.language.isoen
dc.pagina.final344
dc.pagina.inicio332
dc.revistaJournal of the american college of cardiology
dc.rightsacceso restringido
dc.subjectDelphi technique
dc.subjectheart failure
dc.subjectpalliative care
dc.subjectpatient selection
dc.subjectreferral and consultation
dc.subjectsupportive care
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleCriteria for Referral of Patients With Advanced Heart Failure for Specialized Palliative Care
dc.typeartículo
dc.volumen80
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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