Open AccessOutpatient Palliative Care in Heart Failure: An Integrative Review
Author(s) -
Lyndsay DeGroot,
Binu Koirala,
Noelle Pavlovic,
Katie Nelson,
Jerilyn K. Allen,
Patricia M. Davidson,
Martha Abshire Saylor
Publication year - 2020
Publication title -
journal of palliative medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.986
H-Index - 90
eISSN - 1096-6218
pISSN - 1557-7740
DOI - 10.1089/jpm.2020.0031
Subject(s) - cinahl , medicine , palliative care , medline , ethnic group , outpatient clinic , quality of life (healthcare) , cochrane library , family medicine , nursing , alternative medicine , psychological intervention , pathology , sociology , political science , anthropology , law
Background : Early integration of palliative care (PC) for patients with heart failure (HF) improves patient outcomes and decreases health care utilization. PC provided outside of an acute hospitalization is not well understood. Objective : To synthesize the literature of outpatient PC in HF to identify the current landscape, the impact on patient health outcomes, key stakeholders' perspectives, and future implications for research and practice. Design : A systematic search of PubMed, Embase, CINAHL, Cochrane, and Web of Science was conducted from inception to February 2019 for studies of outpatient PC in adults with HF. Each study was analyzed to describe study characteristics, location of PC, types of providers involved, participant characteristics, and main findings, and to characterize domains of PC addressed. Results : Most studies ( N = 19) employed a quantitative design and were conducted in the United States. The most common locations of PC were the home or PC clinic and providers were mainly PC specialists. Outpatient PC improved quality of life, alleviated symptoms, and decreased rehospitalizations for patients with HF. No study addressed all eight domains of PC. The structural, physical, and psychological domains were commonly addressed, whereas, least commonly addressed domains were the cultural and ethical/legal domain. Women and ethnic minorities were underrepresented in the majority of samples. Conclusions : This integrative review highlights the need to promote primary PC and future PC research focusing on a holistic, integrated, team-based approach addressing all domains of PC in representative samples.