Physicians uncertain of therapeutic approaches for heart failure patients

Washington, Feb 12 : Researchers at the Saint Louis University School of Medicine have found that most physicians are uncertain about the approaches to care for heart failure patients.

The survey involving 1,450 physicians has found that most of the physicians were reluctant to refer Palliative care to the patients with end-stage heart failure following uncertainty about timing and patient acceptance of the recommendation.

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.

"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 patient's experience with their illness," said Dr Paul Hauptman, lead author and professor of internal medicine at Saint Louis University School of Medicine.

Palliative care is any form of medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than providing a cure.

"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 patient's prognosis.

"Unlike cancer, for example, predicting death is not always clear with end-stage heart failure," he added.

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

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.

The findings were published in the February 2008 issue of The American Journal of Medicine.

ANI