Design, Creation, and 13-Month Performance of a Novel, Web-Based Activity for Education in Primary Cardiology Palliative Care.

Cardiovascular disease (CVD) clinicians who care for seriously ill patients frequently report that they do not feel confident nor adequately prepared to manage patients' palliative care (PC) needs. With the goal, therefore, of increasing PC knowledge and skills amongst interprofessional clinicians providing CVD care, the ACC's PC Workgroup designed, developed, and implemented a comprehensive PC online educational activity. This paper describes the process and 13-month performance of this free, online activity for clinicians across disciplines and levels of training, "Palliative Care for the Cardiovascular Clinician" (PCCVC).

Palliative Care for People Living With Heart Disease-Does Sex Make a Difference?

The distribution of individual heart disease differs among women and men and, parallel to this, among particular age groups. Women are usually affected by cardiovascular disease at an older age than men, and as the prevalence of comorbidities (like diabetes or chronic pain syndromes) grows with age, women suffer from a higher number of symptoms (such as pain and breathlessness) than men. Women live longer, and after a husband or partner's death, they suffer from a stronger sense of loneliness, are more dependent on institutionalized care and have more unaddressed needs than men.

Scarce-Resource Allocation and Patient Triage During the COVID-19 Pandemic: JACC Review Topic of the Week.

The COVID-19 pandemic and its sequelae have created scenarios of scarce medical resources, leading to the prospect that health care systems have faced or will face difficult decisions about triage, allocation, and reallocation. These decisions should be guided by ethical principles and values, should not be made before crisis standards have been declared by authorities, and, in most cases, will not be made by bedside clinicians. Do not attempt resuscitation and withholding and withdrawing decisions should be made according to standard determination of medical appropriateness and futility, but there are unique considerations during a pandemic.

Influence of depression and gender on symptom burden among patients with advanced heart failure: Insight from the pain assessment, incidence and nature in heart failure study.

Introduction: Patients with advanced heart failure (HF) experience many burdensome symptoms that increase patient suffering.

Methods: Comparative secondary analysis of 347 patients with advanced HF. Symptom burden was measured with the Memorial Symptom Assessment Scale-HF.

Investigating pain in heart failure patients: the pain assessment, incidence, and nature in heart failure (PAIN-HF) study.

Background: Patients with advanced heart failure (HF) have high rates of pain and other symptoms that diminish quality of life. We know little about the characteristics and correlates of pain in patients with advanced HF.

Methods And Results: We identified pain prevalence, location, character, severity, frequency, and correlates in 347 outpatients with advanced HF enrolled from hospices and clinics.

Palliative care in congestive heart failure.

Symptoms and compromised quality of life prevail throughout the course of heart failure (HF) and thus should be specifically addressed with palliative measures. Palliative care for HF should be integrated into comprehensive HF care, just as evidence-based HF care should be included in end-of-life care for HF patients. The neurohormonal and catabolic derangements in HF are at the base of HF symptoms.

End-of-life care in heart failure.

The clinical syndrome of heart failure is increasing in prevalence, as is the number of elderly persons with heart failure. Increasing frailty and progression of heart failure in large numbers of patients means clinicians are increasingly challenged to provide end-of-life care for heart failure patients. End-of-life care has been little studied, but management can be understood from early clinical trials of advanced heart failure.

Investigating pain in heart failure patients: rationale and design of the Pain Assessment, Incidence & Nature in Heart Failure (PAIN-HF) study.

Background: Heart failure is a major cause of morbidity and mortality and is increasing in prevalence. Treatments for heart failure permit a growing number of persons to live with the illness for many years. The burden of symptoms in persons with advanced heart failure is high.

Communication and decision-making about prognosis in heart failure care.

Background: Therapies to prolong life and improve quality of life for heart failure (HF) have expanded in both number and complexity. Clinicians, patients, and families are faced with an array of decisions about interventions with complex risks and benefits. Physicians must also discuss prognosis of HF and its inherent uncertainties.

Development and evaluation of the "Advanced Heart Failure Clinical Competence Survey": a tool to assess knowledge of heart failure care and self-assessed competence.

Objective: We developed a tool to identify self-assessment of skills for advanced HF assessment and management and knowledge of HF care.

Methods: A framework for nursing competency in HF care was developed and its face validity confirmed through expert review. An initial instrument was pilot tested and revised.

Palliative care for end-stage heart failure.

Heart failure is growing in prevalence. Despite an array of treatments targeting a complicated pathophysiology, heart failure ultimately leads to death, and thus there is a clear need to provide palliative care to persons with end-stage heart failure. Palliative care, or education and support of the patient and family and management of distressing symptoms, should be provided throughout the course of the illness.