Unmet Needs in Patients With Heart Failure

The Importance of Palliative Care in a Heart Failure Clinic.


Gonzalez-Jaramillo V, Maessen M, Luethi N, Steffen Eychmüller et al.


For several decades, evidence has shown that patients with heart failure (HF) not only have palliative care (PC) needs comparable to patients with cancer but often for a significantly longer period of time (1). However, in most countries, access to PC for patients with HF is still suboptimal and gaps between PC needs and PC delivery within this patient population are substantial (12). In the 2019 European atlas of PC services (3), only eight European countries reported to have cardiology services that provided PC: the Czech Republic, Denmark, Ireland, the Netherlands, Portugal, Spain, Sweden, and the United Kingdom. The atlas also identified that collaboration between cardiology services and PC specialists occurs only occasionally (3).

Due to the complex needs of patients with HF, HF clinics, consisting of a multidisciplinary team that includes cardiologists, HF-trained nurses, internists, nutritionists, psychologists, physiotherapists, and social workers, are being established across the world to improve patient's HF management (4). According to evidence from observational studies and clinical trials, HF clinics are effective in reducing hospitalizations and all-cause mortality when compared to usual care (57). However, while these clinics are widely available in countries such as Norway and Italy, the current number of HF centers in other countries may not be sufficient to ensure a comprehensive evaluation according to current standards and recommendations (3).

Therefore, more HF clinics and multidisciplinary HF programs will need to be created in the future. Consequently, understanding the PC needs of patients seen in HF clinics, as well as the potential role for PC specialists or of PC-trained staff as part of these teams is crucial. Thus, we conducted this study to understand the unmet PC needs of patients with HF attending an already established HF clinic in a tertiary university teaching hospital in Switzerland.