Xie Kira, Gelfman Laura, Horton Jay R, Goldstein Nathan E
Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Geriatrics Research and Clinical Care Center, James J Peters VA Medical Center, Bronx, New York.
J Card Fail. 2017 Feb;23(2):197-200. doi: 10.1016/j.cardfail.2016.10.013. Epub 2016 Oct 28.
Heart failure (HF) is the most common diagnosis in hospitalized patients older than 65 years of age. Although these patients often need specialist-directed palliative care, <10% ever receive these services. This may be due to a lack of evidence examining the benefits of palliative care for these patients. To understand the current state of research on the interface of palliative care and HF, we examined trends in publications, presentations at national meetings, and National Institutes of Health (NIH) funding.
Using key terms, we identified items about palliative care and HF in the following sources: (1) the tables of contents of nine leading cardiology journals, (2) abstracts of conference proceedings from four cardiology societies, and (3) all NIH grants from 2009 to 2013.
Of the journals reviewed, fewer than 1% of their publications related to palliative care. Less than 2% of HF-related sessions in conference proceedings mentioned palliative care. Of the NIH's $45 billion directed to HF research, only $14 million (0.03%) was spent on palliative care research.
Despite calls for improving palliative care for patients with advanced HF, a lack of sufficient attention persists in research abstracts, concurrent sessions at national meetings, and NIH funding to increase the evidence base. Without these improvements, the ability to deliver high-quality specialist palliative care to patients with HF and their families will remain severely limited.
心力衰竭(HF)是65岁以上住院患者最常见的诊断疾病。尽管这些患者通常需要专科指导的姑息治疗,但接受此类服务的患者不到10%。这可能是由于缺乏对姑息治疗对这些患者益处的研究证据。为了解姑息治疗与心力衰竭交叉领域的研究现状,我们研究了相关出版物的趋势、在全国会议上的报告以及美国国立卫生研究院(NIH)的资助情况。
我们使用关键词,在以下来源中识别有关姑息治疗和心力衰竭的条目:(1)九种领先心脏病学杂志的目录;(2)四个心脏病学学会会议论文集的摘要;(3)2009年至2013年NIH的所有拨款。
在所审查的期刊中,与姑息治疗相关的出版物不到1%。会议论文集中与心力衰竭相关的会议中,提及姑息治疗的不到2%。在NIH用于心力衰竭研究的450亿美元中,仅有1400万美元(0.03%)用于姑息治疗研究。
尽管呼吁改善晚期心力衰竭患者的姑息治疗,但在研究摘要、全国会议同期会议以及NIH资助方面,仍缺乏足够的关注以增加证据基础。如果没有这些改进,为心力衰竭患者及其家属提供高质量专科姑息治疗的能力将仍然受到严重限制。