BMJ 2002;325:915-916 ( 26 October )

Editorials

Palliative care for heart failure

Time to move beyond treating and curing to improving the end of life

The first 150 words of the full text of this article appear below.

The epidemic of heart failure and its costs to health services continue to grow. ^{1 2} Despite important advances in evidence based treatments, age adjusted survival rates for chronic heart failure remain worse than for many forms of cancer. ^{3 4} The only cure for chronic heart failureheart transplantationis equivalent to providing a single lifeboat to the sinking Titanic.

Most of the usually elderly patients with heart failure therefore have short lives remaining of extremely poor quality, punctuated by frequent admissions to hospital. ^{5 6} They often suffer dyspnoea, pain, confusion, anxiety, and depression during their last days of life. Most of them would prefer "comfort care" and do not wish for active resuscitation. Some would even prefer death.⁷ The growing clamour for a better experience of the end of life and the extension of palliative care services to patients with heart failure is therefore not surprising. ^{8 9}

Two recent studies in the BMJ . . . [Full text of this article]

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This article has been cited by other articles:

• McMurray, J., Petrie, M., Swedberg, K., Komajda, M., Anker, S., Gardner, R. (2009). CHAPTER 23 Heart Failure. ESC Textbook of Cardiovascular Medicine 2: med-9780199566990-chapter-med-9780199566990-chapter [Abstract] [Full text]  
• Thompson, D. R (2007). Improving end-of-life care for patients with chronic heart failure. Heart 93: 901-902 [Abstract] [Full text]  
• Selman, L., Harding, R., Beynon, T., Hodson, F., Coady, E., Hazeldine, C., Walton, M., Gibbs, L., Higginson, I. J (2007). Improving end-of-life care for patients with chronic heart failure: "Let's hope it'll get better, when I know in my heart of hearts it won't". Heart 93: 963-967 [Abstract] [Full text]  
• Seamark, D. A, Seamark, C. J, Halpin, D. M G (2007). Palliative care in chronic obstructive pulmonary disease: a review for clinicians. JRSM 100: 225-233 [Abstract] [Full text]  
• Ferrand, E, Jabre, P, Fernandez-Curiel, S, Morin, F, Vincent-Genod, C, Duvaldestin, P, Lemaire, F, Herve, C, Marty, J (2006). Participation of French general practitioners in end-of-life decisions for their hospitalised patients. J. Med. Ethics 32: 683-687 [Abstract] [Full text]  
• Neerkin, J, Riley, J (2006). Ethical aspects of palliative care in lung cancer and end stage lung disease. Chronic Respiratory Disease 3: 93-101 [Abstract]  
• Johnson, M., Houghton, T (2006). Palliative care for patients with heart failure: description of a service. Palliat Med 20: 211-214 [Abstract]  
• Willems, D., Hak, A, Visser, F., Cornel, J, van der Wal, G (2006). Patient work in end-stage heart failure: a prospective longitudinal multiple case study. Palliat Med 20: 25-33 [Abstract]  
• Murray, S. A, Boyd, K., Sheikh, A. (2005). Palliative care in chronic illness. BMJ 330: 611-612 [Full text]  

Rapid Responses:

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SIMPLE RISK-FREE REDUCTION OF PITTING EDEMA IN CONGESTIVE HEART FAILURE PATIENTS

Sharon J Williams, et al.
bmj.com, 1 Jun 2003 [Full text]

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