Implementing patient-centered palliative care therapies,
including prescribing, adjusting or discontinuing
medications as needed, may help control symptoms and improve
quality of life for people with heart disease, according to
"Palliative Pharmacotherapy for Cardiovascular Disease. The
new scientific statement reviews current evidence on the
benefits and risks of cardiovascular and essential
palliative medications. The statement provides guidance for
health care professionals to incorporate palliative methods
as part of holistic medication management at all stages of a
patient's health conditions, emphasizing the importance of
shared decision-making and goal-oriented care. Palliative
care is specialized medical care that aims to relieve
symptoms and enhance quality of life for people experiencing
health-related issues due to serious illnesses. This
approach may benefit patients with cardiovascular disease,
including coronary heart disease, valvular heart disease,
pulmonary arterial hypertension and heart failure. These
conditions significantly reduce quality of life, require
ongoing treatment, are usually progressive and are
associated with high mortality rates. The progression of
many conditions, from chronic to advanced and end-stage, may
be unpredictable and marked by worsening symptoms that
result in recurrent hospitalization. Palliative care
complements standard cardiovascular care by reducing
physical symptoms, managing emotional distress and assisting
patients in making decisions that coincide with their goals
of care. A palliative approach can be integrated into the
medication management of patients at any stage of heart
disease, from chronic, stable heart disease to advanced and
end-stage cardiovascular disease. And, importantly,
palliative care supports a more goal-oriented,
patient-centered approach to treatment. Previous studies
have found that adding palliative care interventions to
evidence-based care improved patients' quality of life,
functional status, depression, anxiety and spiritual
well-being and reduced the risk of hospital readmission for
patients with advanced heart disease compared to clinical
care alone. Despite these benefits, fewer than 20% of people
with end-stage heart disease receive palliative care. In
addition, People with heart failure who are referred to
palliative care are predominantly white, have higher
socioeconomic status and are more likely to receive care at
academic medical centers. To achieve these goals,
cardiovascular medications that provide symptom relief, such
as diuretics to manage fluid retention in heart failure,
should be prioritized in patients with advanced heart
disease. Adding palliative medicines to evidence-based
cardiovascular therapies can be complementary to manage
symptoms and optimize quality of life. Examples of common
palliative medicines include antidepressants, opioids for
pain relief and difficulty breathing, and anti-nausea
medications. |