Nationwide survey of palliative care for patients with heart failure in Japan

Takashi Kuragaichi, Yuma Kurozumi, Shogo Ohishi, Yasuo Sugano, Akihiro Sakashita, Norihiko Kotooka, Makoto Suzuki, Taiki Higo, Dai Yumino, Yasuko Takada, Seiko Maeda, Saori Yamabe, Koichi Washida, Tomonori Takahashi, Tomohito Ohtani, Yasushi Sakata, Yukihito Sato

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11 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1336-1343
Number of pages8
JournalCirculation Journal
Volume82
Issue number5
DOIs
Publication statusPublished - 2018

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Kuragaichi, T., Kurozumi, Y., Ohishi, S., Sugano, Y., Sakashita, A., Kotooka, N., Suzuki, M., Higo, T., Yumino, D., Takada, Y., Maeda, S., Yamabe, S., Washida, K., Takahashi, T., Ohtani, T., Sakata, Y., & Sato, Y. (2018). Nationwide survey of palliative care for patients with heart failure in Japan. Circulation Journal, 82(5), 1336-1343. https://doi.org/10.1253/circj.CJ-17-1305