Symptom management challenges in heart failure: pharmacotherapy considerations. [Review]

MedStar author(s):
Citation: Heart Failure Reviews. 22(5):525-534, 2017 Sep.PMID: 28646467Institution: MedStar Washington Hospital CenterDepartment: PharmacyForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Cardiovascular Agents/tu [Therapeutic Use] | *Drug Monitoring/mt [Methods] | *Heart Failure/dt [Drug Therapy] | *Palliative Care/mt [Methods] | *Quality of Life | Humans | United StatesYear: 2017Local holdings: Available online from MWHC library: 1997 - presentAvailable online from MWHC library: 1997 - presentISSN:
  • 1382-4147
Name of journal: Heart failure reviewsAbstract: Heart failure is a chronic, progressive illness that is increasing in prevalence in the USA. Patients with advanced heart failure experience a high symptom burden that is comparable to patients with advanced cancer. Palliative care, however, is underutilized in patients with heart failure, and symptoms may go untreated as the disease progresses. A combination of pharmacologic and non-pharmacologic interventions should be used to address symptoms and maintain quality of life. While there have been significant advances in evidence-based heart failure treatments in recent years, selection of appropriate palliative medications as symptoms progress is challenging due to limited clinical studies in this patient population. Medications that are commonly used for symptom management in other life-limiting illnesses may have little to no evidence in heart failure, or have undesirable cardiac effects that preclude use. Clinicians must extrapolate available clinical evidence and prescribing considerations relevant to heart failure to palliate symptoms as well as possible. The objectives of this paper are to review the most common and distressing symptoms in heart failure, analyze evidence, or lack thereof, for pharmacologic management of symptoms, and provide prescribing considerations based on side effect profiles and comorbid conditions.All authors: McPherson ML, Stewart DOriginally published: Heart Failure Reviews. , 2017 Jun 24Fiscal year: FY2018Fiscal year of original publication: FY2017Digital Object Identifier: Date added to catalog: 2017-07-10
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 28646467 Available 28646467

Available online from MWHC library: 1997 - present

Available online from MWHC library: 1997 - present

Heart failure is a chronic, progressive illness that is increasing in prevalence in the USA. Patients with advanced heart failure experience a high symptom burden that is comparable to patients with advanced cancer. Palliative care, however, is underutilized in patients with heart failure, and symptoms may go untreated as the disease progresses. A combination of pharmacologic and non-pharmacologic interventions should be used to address symptoms and maintain quality of life. While there have been significant advances in evidence-based heart failure treatments in recent years, selection of appropriate palliative medications as symptoms progress is challenging due to limited clinical studies in this patient population. Medications that are commonly used for symptom management in other life-limiting illnesses may have little to no evidence in heart failure, or have undesirable cardiac effects that preclude use. Clinicians must extrapolate available clinical evidence and prescribing considerations relevant to heart failure to palliate symptoms as well as possible. The objectives of this paper are to review the most common and distressing symptoms in heart failure, analyze evidence, or lack thereof, for pharmacologic management of symptoms, and provide prescribing considerations based on side effect profiles and comorbid conditions.

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