000			03520nam a22004937a 4500
008			180802s20192019 xxu||||| |||| 00| 0 eng d
022			_a1049-9091
024			_a10.1177/1049909118789338 [doi]
040			_aOvid MEDLINE(R)
099			_a30037272
245			_aGetting to the Heart of the Matter: A Regional Survey of Current Hospice Practices Caring for Patients With Heart Failure Receiving Advanced Therapies.
251			_aAmerican Journal of Hospice & Palliative Medicine. 36(1):55-59, 2019 Jan.
252			_aAm J Hosp Palliat Care. 36(1):55-59, 2019 Jan.=790 \\ _aGroninger H
253			_aThe American journal of hospice & palliative care
260			_c2019
260			_fFY2019
266			_d2018-08-02
269			_fFY2018
520			_aBACKGROUND: No guidelines exist regarding care for patients with advanced heart failure (HF) receiving hospice care while continuing advanced HF therapies such as left ventricular assist devices (LVADs) or continuous inotropes.
520			_aCONCLUSIONS: Hospice specialists reported widely varied practice experiences caring for patients with HF receiving advanced therapies, noted specific challenges for care of these patients, and expressed a desire for targeted HF education.
520			_aDESIGN: Cross-sectional survey of hospice clinical and administrative leaders.
520			_aOBJECTIVE: We surveyed hospice providers in our tristate region to determine hospice demographics, current practices for care of patients with advanced HF, and perceived challenges of providing advanced HF therapies.
520			_aRESULTS: Forty-six respondents representing 23 hospices completed the survey. Over half (27/46) held leadership administrative roles, and most (37/46) had more than 5 years of hospice experience. Although lack of experience and cost were cited as primary barriers to providing inotrope therapy in home hospice, about half of respondents (24/46) said they would manage inotropes. All participants said their respective hospices accept patients with implantable cardioverter-defibrillators; over half (28/46) said they accept patients with LVADs into hospice care. Lack of experience with LVADs was the most frequently cited barrier. Most participants were interested in training and support by an advanced HF program to facilitate hospice care of patients receiving these advanced therapies. General access to hospice services for patients with HF at their organization was considered adequate by 30 of 46 participants. Most (32/46) reported that referrals are made too late.
546			_aEnglish
650			_a*Defibrillators, Implantable
650			_a*Heart Failure/th [Therapy]
650			_a*Heart-Assist Devices
650			_a*Hospice Care/og [Organization & Administration]
650			_a*Palliative Care/og [Organization & Administration]
650			_aCross-Sectional Studies
650			_aHospice Care/st [Standards]
650			_aHumans
650			_aPalliative Care/st [Standards]
651			_aMedStar Health Research Institute
651			_aMedStar Washington Hospital Center
656			_aMedicine/Palliative Care
657			_aJournal Article
700			_aGroninger, Hunter
700			_aWalker, Kathryn A
790			_aGilhuly D, Walker KA
856			_uhttps://dx.doi.org/10.1177/1049909118789338 _zhttps://dx.doi.org/10.1177/1049909118789338
858			_yGroninger, Hunter _uhttp://orcid.org/0000-0001-7416-1999 _zhttp://orcid.org/0000-0001-7416-1999
942			_cART _dArticle
999			_c11140 _d11140