The Importance of Patient-Centered Palliative Care Therapies in Cardiovascular Disease Management
Implementing patient-centered palliative care therapies, including prescribing, adjusting, or discontinuing medications as needed, may help control symptoms and improve the quality of life for people with heart disease. This new approach is highlighted in the scientific statement, “Palliative Pharmacotherapy for Cardiovascular Disease,” recently published in the American Heart Association’s journal, Circulation: Cardiovascular Quality and Outcomes.
In this article, we will delve into the significance of incorporating palliative care methods in cardiovascular disease management and explore the benefits and challenges associated with this approach. Palliative care is a specialized form of medical care focused on relieving symptoms and enhancing the quality of life for individuals facing serious illnesses.
The Role of Palliative Care in Cardiovascular Disease Management
Individuals with cardiovascular diseases such as coronary heart disease, valvular heart disease, pulmonary arterial hypertension, and heart failure often experience a significant reduction in their quality of life. These conditions require ongoing treatment, are progressive in nature, and can lead to recurrent hospitalizations due to worsening symptoms.
Integrating palliative care into the standard cardiovascular care of patients at all stages of heart disease can help in addressing physical symptoms, managing emotional distress, and assisting patients in aligning their treatment goals with their overall care plan. By adopting a patient-centered approach, healthcare professionals can cater to the individual needs and preferences of each patient, thereby improving their overall well-being.
Benefits and Challenges of Palliative Care in Cardiovascular Disease
Past studies have shown that integrating palliative care interventions alongside evidence-based treatments has led to improved quality of life, functional status, and emotional well-being for patients with advanced heart disease. Despite these positive outcomes, fewer than 20% of individuals with end-stage heart disease currently receive palliative care.
Additionally, disparities in care and outcomes persist among patients with heart failure, particularly concerning race, ethnicity, gender, and socioeconomic status. White patients with higher socioeconomic status are more likely to receive palliative care, leading to better outcomes and reduced mortality rates. Patients from underrepresented racial and ethnic groups face barriers in accessing palliative care, resulting in poorer health outcomes.
Medication Management and Palliative Care Strategies
One crucial aspect of palliative care in cardiovascular disease management is the judicious use of medications to provide symptom relief and enhance the quality of life for patients. Common palliative medicines such as diuretics for managing fluid retention in heart failure, antidepressants, opioids for pain relief, and anti-nausea medications can be beneficial in improving the overall well-being of patients.
Furthermore, the statement emphasizes the importance of deprescribing and de-escalating medications in palliative medication management for individuals with heart disease. Deprescribing involves tapering, withdrawing, or discontinuing medications that may have limited benefits or pose a risk of adverse effects. De-escalating medications focuses on reducing doses or switching to alternative treatments based on the patient’s response.
Future Perspectives and Recommendations
As the field of palliative care in cardiovascular disease continues to evolve, there is a need for further research to explore the best practices for providing timely and targeted access to palliative medication management. Particularly, efforts are required to address the disparities in care and outcomes among underrepresented racial and ethnic groups who may face barriers to receiving palliative care.
In conclusion, the integration of patient-centered palliative care therapies in cardiovascular disease management can significantly improve the quality of life and overall well-being of individuals with heart disease. By prioritizing holistic medication management, healthcare professionals can ensure that patients receive personalized care that aligns with their treatment goals and preferences.
“It is critical for patients to be fully informed about their diagnosis and how medication management may change throughout the disease progression so they have ample time to set and share their goals,” said Chair of the statement writing group Katherine E. Di Palo, Pharm.D., M.B.A., M.S., FAHA. “These goals often include reducing symptoms such as shortness of breath, fatigue, and pain as well as improving sleep, mood, and appetite.”
Together, healthcare professionals, patients, and caregivers can work towards implementing patient-centered palliative care strategies that prioritize symptom management, quality of life, and shared decision-making for individuals with heart disease.
