Elements of Integrated Palliative Care in Chronic Heart Failure Across the Care Continuum: A Scoping Review

Gursharan K Singh; Serra E Ivynian; Patricia M Davidson; Caleb Ferguson; Louise D Hickman

doi:10.1016/j.hlc.2021.08.012

Elements of Integrated Palliative Care in Chronic Heart Failure Across the Care Continuum: A Scoping Review

Heart Lung Circ. 2022 Jan;31(1):32-41. doi: 10.1016/j.hlc.2021.08.012. Epub 2021 Sep 27.

Authors

Gursharan K Singh¹, Serra E Ivynian², Patricia M Davidson³, Caleb Ferguson⁴, Louise D Hickman²

Affiliations

¹ Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Qld, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology (QUT), Brisbane, Qld, Australia. Electronic address: gursharan.singh@qut.edu.au.
² Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
³ School of Nursing, Johns Hopkins University, Baltimore, MD, USA & Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
⁴ School of Nursing & Midwifery, Western Sydney University, Penrith, NSW, Australia; Western Sydney Local Health District, Blacktown Hospital, Sydney, NSW, Australia.

PMID: 34593316
DOI: 10.1016/j.hlc.2021.08.012

Abstract

Background: Individuals with chronic heart failure experience high symptom burden, reduced quality of life and high health care utilisation. Although there is growing evidence that a palliative approach, provided concurrently with usual treatment improves outcomes, the method of integrating palliative care for individuals living with chronic heart failure across the care continuum remains elusive.

Aim: To examine the key elements of integrated palliative care recommended for individuals living with chronic heart failure across the care continuum.

Design: Scoping review.

Data sources: Databases searched were CINAHL, Ovid MEDLINE, Scopus and OpenGrey. Studies written in English and containing key strategic elements specific to chronic heart failure were included. Search terms relating to palliative care and chronic heart failure and the Joanna Briggs Institute methodology for scoping reviews was used.

Results: Seventy-nine (79) articles were selected that described key elements to integrate palliative care for individuals with chronic heart failure. This review identifies four levels of key strategic elements: 1) clinical; 2) professional; 3) organisational and 4) system-level integration. Implementing strategies across these elements facilitates integrated palliative care for individuals with chronic heart failure.

Conclusions: Inter-sectorial collaborations across systems and the intersection of health and social services are essential to delivering integrated, person-centred palliative care. Further research focussing on patient and family needs at a system-level is needed. Research with strong theoretical underpinnings utilising implementation science methods are required to achieve and sustain complex behaviour change to translate key elements.

Keywords: Heart failure; Implementation science; Knowledge translation; Palliative care; Scoping review; Supportive care.

Copyright © 2021 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Publication types

Review

MeSH terms

Chronic Disease
Continuity of Patient Care
Heart Failure* / therapy
Humans
Palliative Care*
Quality of Life