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

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...

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Bibliographic Details
Published in:Heart, lung & circulation lung & circulation, 2022-01, Vol.31 (1), p.32-41
Main Authors: Singh, Gursharan K., Ivynian, Serra E., Davidson, Patricia M., Ferguson, Caleb, Hickman, Louise D.
Format: Article
Language:English
Subjects:
Chronic Disease
Continuity of Patient Care
Heart failure
Heart Failure - therapy
Humans
Implementation science
Knowledge translation
Palliative Care
Quality of Life
Scoping review
Supportive care
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Summary: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. To examine the key elements of integrated palliative care recommended for individuals living with chronic heart failure across the care continuum. Scoping review. 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. 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. 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.
ISSN:1443-9506
1444-2892
DOI:10.1016/j.hlc.2021.08.012