Prevalence and characteristics of patients with heart failure needing palliative care

Luisa Fernanda Arenas Ochoa, Valentina González-Jaramillo, Clara Saldarriaga, Mariantonia Lemos, Alicia Krikorian, John Jairo Vargas, Xavier Gómez-Batiste, Nathalia Gonzalez-Jaramillo, Steffen Eychmüller

    Research output: Contribution to journalArticleResearchpeer-review

    2 Scopus citations


    Background: Few hospitals and heart failure (HF) clinics offer concurrent palliative care (PC) together with life-prolonging therapies. To know the prevalence of patients in HF clinics needing PC and useful tools to recognize them are the first steps to extending PC in those settings. However, it is still unknown whether tools commonly used to identify patients with HF needing PC can correctly distinguish them. Two systematic reviews found that the NECesidades PALiativas (NECPAL) tool was one of the two most commonly used tools to asses PC needs in HF patients. Therefore, we assessed 1) the prevalence of PC needs in HF clinics according to the NECPAL tool, and 2) the characteristics of the patients identified as having PC; mainly, their quality of life (QoL), symptom burden, and psychosocial problems. Methods: This cross-sectional study was conducted at two HF clinics in Colombia. We assessed the prevalence of PC in the overall sample and in subgroups according to clinical and demographic variables. We assessed QoL, symptom burden, and psychosocial problems using the 12-Item Short-Form Health Survey (SF-12), the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Edmonton Symptom Assessment System (ESAS). We compared the results of these tools between patients identified as having PC needs (+NECPAL) and patients identified as not having PC needs (–NECPAL). Results: Among the 178 patients, 78 (44%) had PC needs. The prevalence of PC needs was twice as nigh in patients NYHA III/IV as in patients NYHA I/II and almost twice as high in patients older than 70 years as in patients younger than 70 years. Compared to –NECPAL patients, +NECPAL patients had worse QoL, more severe shortness of breath, tiredness, drowsiness, and pain, and more psychosocial problems. Conclusion: The prevalence of PC needs in outpatient HF clinics is high and is even higher in older patients and in patients at more advanced NYHA stages. Compared to patients identified as not having PC needs, patients identified as having PC needs have worse QoL, more severe symptoms, and greater psychosocial problems. Including a PC provider in the multidisciplinary team of HF clinics may help to assess and cover these needs.

    Original languageEnglish
    Article number184
    JournalBMC Palliative Care
    Issue number1
    StatePublished - Dec 2021

    Bibliographical note

    Funding Information:
    The authors acknowledge the support with the data collection and logistics provided by Laura Montoya, Maria Camila Zapata, Federico Toro, James Samir Diaz and Adriana Maria Agudelo. We also thank Christopher Ritter for editorial assistance. Finally, we thank the patients and their families who dedicated their time to providing the information that made this study possible.

    Publisher Copyright:
    © 2021, The Author(s).


    • Health services needs and demands
    • Heart failure
    • Needs assessment
    • Palliative care
    • Patient-centered care
    • Prognosis


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