Key result
A nationwide survey of 544 Japanese cardiology hospitals found that 98% consider palliative care necessary for heart failure, but only 42% hold palliative care conferences.
Cross-Sectional (n=544)
Yes
This nationwide survey in Japan highlights that while most cardiology training hospitals recognize the need for palliative care in heart failure, actual implementation, such as multidisciplinary conferences and early advance care planning, remains limited.
Despite high recognition, palliative care conference use remains low in HF; leaves open how to bridge this implementation gap.
BACKGROUND: Palliative care for heart failure (HF) patients is recommended in Western guidelines, so this study aimed to clarify the current status of palliative care for HF patients in Japan. METHODS AND RESULTS: A survey was sent to all Japanese Circulation Society-authorized cardiology training hospitals (n=1,004) in August 2016. A total of 544 institutions (54%) returned the questionnaire. Of them, 527 (98%) answered that palliative care is necessary for patients with HF. A total of 227 (42%) institutions held a palliative care conference for patients with HF, and 79% of the institutions had <10 cases per year. Drug therapy as palliative care was administered at 403 (76%) institutions; morphine (87%) was most frequently used. Among sedatives, dexmedetomidine (33%) was administered more often than midazolam (29%) or propofol (20%). Regarding the timing of end-of-life care, most institutions (84%) reported having considered palliative care when a patient reached the terminal stage of HF. Most frequently, the reason for the decision at the terminal stage was "difficulty in discontinuing cardiotonics." A major impediment to the delivery of palliative care was "difficulty predicting an accurate prognosis." CONCLUSIONS: This large-scale survey showed the characteristics of palliative care for HF in Japan. The present findings may aid in the development of effective end-of-life care systems.
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Kuragaichi et al. (2018) conducted a cross-sectional in Heart Failure (n=544). Palliative care survey was evaluated on Current status of palliative care for HF patients. A nationwide survey of 544 Japanese cardiology hospitals found that 98% consider palliative care necessary for heart failure, but only 42% hold palliative care conferences.
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