Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Heart Failure
Nationwide Survey of Palliative Care for Patients With Heart Failure in Japan
Takashi KuragaichiYuma KurozumiShogo OhishiYasuo SuganoAkihiro SakashitaNorihiko KotookaMakoto SuzukiTaiki HigoDai YuminoYasuko TakadaSeiko MaedaSaori YamabeKoichi WashidaTomonori TakahashiTomohito OhtaniYasushi SakataYukihito Sato
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Supplementary material

2018 Volume 82 Issue 5 Pages 1336-1343

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Abstract

Background:Palliative care for heart failure (HF) patients is recommended in Western guidelines, so this study aimed to clarify the current status of palliative care for HF patients in Japan.

Methods and Results:A survey was sent to all Japanese Circulation Society-authorized cardiology training hospitals (n=1,004) in August 2016. A total of 544 institutions (54%) returned the questionnaire. Of them, 527 (98%) answered that palliative care is necessary for patients with HF. A total of 227 (42%) institutions held a palliative care conference for patients with HF, and 79% of the institutions had <10 cases per year. Drug therapy as palliative care was administered at 403 (76%) institutions; morphine (87%) was most frequently used. Among sedatives, dexmedetomidine (33%) was administered more often than midazolam (29%) or propofol (20%). Regarding the timing of end-of-life care, most institutions (84%) reported having considered palliative care when a patient reached the terminal stage of HF. Most frequently, the reason for the decision at the terminal stage was “difficulty in discontinuing cardiotonics.” A major impediment to the delivery of palliative care was “difficulty predicting an accurate prognosis.”

Conclusions:This large-scale survey showed the characteristics of palliative care for HF in Japan. The present findings may aid in the development of effective end-of-life care systems.

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© 2018 THE JAPANESE CIRCULATION SOCIETY
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