Heart failure patients experience a disease burden and palliative care needs comparable to those with cancer. Despite these significant needs, palliative care is often not offered in a timely manner to these patients. A primary obstacle is the challenge in effectively identifying heart failure patients who would benefit from palliative care interventions. Several tools designed to assess and measure palliative care needs have been utilized to aid in identifying these individuals and evaluating their specific requirements. However, the question remains: which palliative care screening tool is the most appropriate for heart failure populations?
This article addresses this critical question by examining the landscape of palliative care needs assessment tools for heart failure patients. It draws upon a comprehensive review of existing research, which systematically investigated various tools to determine their suitability for this specific patient group. The review encompassed a broad search across major databases including Cochrane Library, MEDLINE Complete, AMED, PsycINFO, CINAHL Complete, EMBASE, EThOS, alongside tool-specific websites and relevant citations, covering literature from inception up to June 25, 2020. Studies included in the review evaluated palliative care needs assessment tools within heart failure populations, focusing on tool development, psychometric properties, and their effectiveness in identifying patients needing palliative care.
The research synthesis included twenty-seven papers, representing nineteen distinct studies. The majority of these studies employed quantitative and observational designs. The analysis identified six prominent tools used for palliative care needs assessment in heart failure. These tools were rigorously compared across several dimensions: content coverage, context of application, development process, psychometric properties, and their demonstrated clinical utility in identifying patients with palliative care needs.
While acknowledging the limitations of the current evidence base, the review concluded that the Needs Assessment Tool: Progressive Disease – Heart Failure (NAT:PD-HF) stands out as the most promising palliative care needs-assessment tool for heart failure populations. The NAT:PD-HF demonstrated comprehensive coverage of patient needs, exhibited the strongest psychometric properties among the tools evaluated, and presented evidence supporting its ability to identify patients appropriately and effectively.
Despite this promising finding, the review emphasizes the ongoing need for further research. Specifically, more robust psychometric testing of palliative care screening tools within heart failure patient populations is crucial. Furthermore, evaluating the effectiveness of these tools in real-world clinical settings to accurately identify individuals who would most benefit from palliative care remains a priority for future investigation. Continued research in this area is essential to ensure that heart failure patients receive timely and appropriate palliative care, ultimately improving their quality of life and overall care experience.
