Improving Palliative Care for Patients with Heart Failure and Family Caregivers: Results from a National Working Group Examining Clinical and Research Priorities for Heart Failure and Palliative Care (TH309)

Abstract

•Review results from the June 2015 Clinical & Research Priorities for Heart Failure and Palliative Care National Symposium of cardiology and palliative experts (funded by the John A. Hartford Foundation, American Federation for Aging Research, National Palliative Care Research Center, University of Alabama-Birmingham, and Icahn School of Medicine at Mount Sinai), which focused on the barriers to and opportunities for improving palliative care integration among patients with advanced cardiac disease.•Discuss opportunities and strategies for collaboration of palliative care and heart failure within the domains of research, clinical care, and policy change.•Identify two specific implementation projects to improve care for patients with advanced heart failure within each area of research, clinical programs, and policy. Hospital readmission rates, mortality rates, and Medicare costs for patients with heart failure (HF) are high. Patients with HF are burdened by multiple symptoms that increase as the disease progresses. Because HF carries a substantial burden, it is critical to understand how palliative care can contribute to improving the quality of care for this population. Yet, the evidence base demonstrating the benefits of palliative care on outcomes and quality of care in patients with HF is still lacking. Change can only happen with an interdisciplinary, explicit strategic change approach. We conducted a series of telephonic nominal groups followed by a 2-day in-person symposium, which pulled together a group of interdisciplinary, nationally-recognized clinicians, investigators, and policy experts representing HF, geriatrics, and palliative care to address the following 3 questions: 1) What are the greatest challenges and barriers faced in HF regarding the integration of palliative care? 2) What are the state of the science and gaps in knowledge regarding patients with advanced HF and their family caregivers? 3) What are the most successful care models or strategies that are currently making a difference in HF care? The purpose of this concurrent session is to 1) describe the methods we used to develop consensus of strategies for each of these domains and 2) detail symposium results and achievements. The overall goal is to build support for a national agenda to advance the field of palliative care for patients with HF and their family caregivers. Specifically, we will review proposed research, clinical demonstration projects, national guidelines, and policy to develop priorities for implementation and endorsement. We will also describe and solicit additional input to create sustainable working groups that can formulate research, policy, and practice priorities and potential opportunities for collaboration and funding in order to develop a sustainable model for future collaboration.