Use of Palliative Care on the Rise in Veterans With Severe HF

The use of palliative care in veterans with severe heart failure (HF) doubled over the course of six years, according to a research letter published July 6 in JAMA Cardiology.

The study, conducted from 2007 to 2013, comprised a cross-sectional analysis of patients in the Veterans Affairs Healthcare System. Using Veterans Affairs External Peer Review Program data, the authors identified 4,474 patients with severe HF and found that 7.6 percent (338) were seen by palliative care one year after the index HF hospitalization.

Overall, 51.2 percent of HF patients died within one year of hospitalization. Those who died were more likely to have been seen by palliative care; those seen by palliative care had a one-year mortality of 72.8 percent. Among those who were not seen by palliative care, the mortality rate was 49.5 percent. 

According to the authors, while palliative care use rates doubled during the study’s timeline, the absolute rate remained low at 7.6 percent. They explain that the study had some limitations, including a lack of data on symptoms or patient preference, as well as a predominantly male population. But they note that the study had strengths as well, including its “analysis of the largest integrated health care system in the U.S.,” as well as its assessment of palliative care use up to one year post-HF hospitalization.

Moving forward, the authors conclude that “our data suggest the potential to improve use of palliative care in severe HF.”

Clinical Topics: Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: Cross-Sectional Studies, Delivery of Health Care, Integrated, Heart Failure, Hospitalization, Palliative Care, Patient Preference, Peer Review, Veterans

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