Necessary assesment tools to recognize the needs for palliative care in patients with heart failure. Systematic literature review

As. med. licențiat Roxana Ionela Slăbuțu2, Șef lucrări. as. med. dr. Nicoleta Mitrea 1,2

1Facultatea de Medicină, Universitatea Transilvania Brașov, România,2 Asistent medical principal licențiat

Primit: 7.07.2022 • Acceptat pentru publicare: 15.07.2022


Introduction: Heart failure (HF) patients have palliative care (PC) needs comparable to those of cancer patients, but few receive PC. Several palliative care needs assessment tools have been used among patients with HF to identify their needs, but it is not clear which tool is the most appropriate to use, for patients with HF.

Method: literature searches were conducted on systematic review articles, mixed review articles, clinical trials collected from platforms: PubMed, Cochrane Library, Medline Complete, Medline, EMBASE, Medscape, Google Scholar and SCI-hub, the websites of the instruments identified, as well as in the references and citations of the included studies. Studies were considered for review if they presented tools to assess the needs of PC for patients with HF.

Results: Of the 20,300 unique articles 40 reported the use or development of screening tools specific to people diagnosed with HF and with potential PC needs. The accuracy of 46 tools was assessed in ten studies, which studies are presented; these tools varied significantly in their ability to identify HF patients with significant PC needs and included general and specific indicators for HF disease.

Discussion: Of the 46 tools listed and reviewed, seven were represented by NAT: PD-HF (Needs Assessment Tool: Progressive Disease-HF), achieving the highest percentage of appearance in the literature reviews. The middle percentage is represented by NECPAL (NECesidades Paliativas – Palliative Needs) and RADPAC (RADboud indicators for PAlliative Care Needs) tools which appear in equal numbers each. None of the instruments included in this analysis met all psychometric criteria.

Conclusions: This paper provides preliminary evidence for NAT: PD-HF as a potential strategy for the identification and management of physical impairments and psychosocial problems experienced by people with HF. NAT: PD-HF has relatively wide applicability in HF populations and is used for both patient identification and identification of patient needs. Further research is needed to identify standardized screening processes that are based not only on predicting mortality and deterioration, but also on anticipating PC needs and predicting the rate and trajectory of functional decline.

 Keywords: heart failure, assessment tools, palliative care

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