Navigation Links
Doctors uncertain about approaches to care for heart failure patients, SLU study finds

ST. LOUIS Less than one fourth of physicians specializing in geriatrics, internal or family medicine or cardiology believe they can accurately predict the whether patients with heart failure are at risk of dying, new Saint Louis University research found.

The ability to determine whether patients are within six months of death is crucial to clinical care, impacting key patient-care decisions such as therapeutic approaches and referral for palliative care, which is focused on symptom relief rather than cure.

Our findings are important not only in light of the increasing prevalence of heart failure in the United States but because the data show that there are considerable gaps in knowledge regarding end-stage heart failure that ultimately affect a patients experience with their illness, says Paul Hauptman, M.D., professor of internal medicine at Saint Louis University School of Medicine and the studys lead author.

Palliative measures can be adopted to ease the pain of patients with terminal heart failure, but these measures are not always utilized because of uncertainty about the patients prognosis. Unlike cancer, for example, predicting death is not always clear with end-stage heart failure.

Across the board, physicians reported that they were unlikely to refer a patient with end-stage heart failure for hospice care. Their reluctance was due in part to uncertainty about timing and patient acceptance of the recommendation.

This study will provide valuable insight into physicians beliefs and biases in regards to end-stage heart failure, Hauptman said. This area has not been previously explored, but is essential if we are to design interventions to help physicians select appropriate care options for their patients.

Among the three specialties studied, geriatricians were the most confident in predicting six-month mortality. Physicians who work in group practices, have large clinical volume, and those who had formal training in palliative care, express a willingness to objectively measure functional status and refer patients to hospice care were more confident in predicting six-month mortality.

End-stage heart failure or terminal heart failure is characterized by fatigue, shortness of breath, progressive muscle wasting and inability to exercise despite optimal medical and surgical therapy.

The study also provides insight into existing knowledge gaps regarding appropriate monitoring of patients and selection of management options.

Very few physicians, for example, ask patients to complete quality-of-life questionnaires or objectively measure functional status, two key factors that help determine a patients status.

This failure suggests that physicians may not appropriately recognize the impact of heart failure on their patients, Hauptman says.

The study also found that doctors rarely discuss deactivating implantable cardioverter defibrillators with very sick heart failure patients and their families.

Implantable cardioverter defibrillators detect cardiac arrhythmias and correct the condition by delivering an electrical shock. For people who are at risk of sudden cardiac death, this device can be a life saver.

For patients with advanced heart disease, though, an implantable cardioverter-defibrillator can cause unnecessary discomfort and stress because it can continue to deliver shocks as the patient is dying. While the majority of physicians surveyed agreed that deactivating the device is appropriate with end-stage heart failure, very few heed this advice.

Using a random stratified survey, 1,450 physicians (600 cardiologists, 300 geriatricians and 300 internal and family medicine doctors), were polled for the study. Approximately 60 percent of physicians polled responded to the survey.


Contact: Sara Savat
Saint Louis University

Related medicine news :

1. Doctors will soon be able to feel organs via a display screen
2. Depression in Young Doctors Tied to Medication Errors
3. Looking for a Career? A New Study Shows Demand for Doctors of Podiatric Medicine to Surge Over the Next Six Years
4. Parents Identify Health Topics They Want Doctors to Discuss with Kids - New Research for University of Michigan Conducted by Knowledge Networks
5. On Heels of SCHIP Veto, President Advocates Eliminating Federal Funding for Training Childrens Doctors
6. VIDEO from Medialink and Siemens: Doctors Trade in their Stethoscopes for Microphones
7. Are People Asking Their Doctors?: Halo Rejuvenator a Holistic Remedy for Headache, Neck and Shoulder Pain
8. Doctors Review End-of-Life Care Guidelines
9. UCI Medical Affiliates Inc. Opens New Doctors Care Center in Florence
10. Study Finds Doctors Not Reporting Medical Mistakes
11. Almost Half of Doctors Have Prescribed Placebos
Post Your Comments:
(Date:12/1/2015)... ... 2015 , ... With FCPX Overlay: Grit , users can apply a ... possibilities are truly endless, all with a click of a mouse. Each user has ... flip, depth of field and more, all within Final Cut Pro X. , With ...
(Date:12/1/2015)... (PRWEB) , ... December 01, 2015 , ... ... Contact Center Enterprise Authorized Technology Provider (ATP) status from Cisco. This designation recognizes ... and support Cisco Unified Contact Center solutions targeted to the high-end enterprise contact ...
(Date:11/30/2015)... Turks & Caicos Islands, BWI (PRWEB) , ... December 01, 2015 ... ... in 2015. Recently Caribbean Journal, one of the leading digital news sites highlighting ... The top reason? The weather. While much of North America shivers under chilly ...
(Date:11/30/2015)... ... November 30, 2015 , ... ... the19th Bi-National Convention of the Federation of Philippine American Chambers of Commerce held ... Vegas, Nevada. , 1Heart Caregiver Services, as an active delegate from the ...
(Date:11/30/2015)... , ... November 30, 2015 , ... ... (Meso Foundation) released information for caregivers and held two webinars on topics of ... on demand free of charge at . , With a loved ...
Breaking Medicine News(10 mins):
(Date:11/30/2015)... 30, 2015 ... "Orphan Drugs Market 2015-2019" report to their ... the addition of the "Orphan Drugs Market ... Research and Markets ( ) has ... Market 2015-2019" report to their offering. ...
(Date:11/30/2015)... Nov. 30, 2015   Royal Philips (NYSE: ... the industry,s first MRI guided user interface and automatic ... patients with MR Conditional implants, such as knee and ... 2015 Radiological Society of North America Annual Meeting (RSNA) ... supports diagnostic confidence of this growing patient population. ScanWise ...
(Date:11/30/2015)... November 30, 2015 ... adds a 2015 publication ... - 2015 with comprehensive analysis of ... of deal types, such as Mergers ... . ...
Breaking Medicine Technology: