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Continuous Inotrope Therapy in Hospice Care: A Case Series
- Source :
- American Journal of Hospice and Palliative Medicine®. 36:660-663
- Publication Year :
- 2019
- Publisher :
- SAGE Publications, 2019.
-
Abstract
- Continuous cardiac inotropes are increasingly utilized for symptom management in advanced heart failure (AHF). Among patients who are not eligible for cardiac transplant or mechanical circulatory support, many are hospice eligible at the time of inotrope initiation. Nevertheless, given relative infrequent use as well as cost issues, acceptability and management of inotropes in the hospice setting are likely widely variable between hospice agencies.To describe hospice care experiences for patients with AHF receiving continuous inotrope therapies and weaning inotropes at the end of life.Single-institution retrospective chart review of patients with AHF receiving continuous inotropes who were discharged from the hospital to hospice care between February 2015 and October 2016 and survey of hospice medical directors providing direct care of these patients.Eighteen patients with AHF receiving continuous inotropes were discharged to 6 hospice agencies. Twelve patients were weaned from inotropes prior to death. Among cases where the inotrope was weaned, patients lived several days to more than 2 weeks. All hospice medical directors surveyed would accept patients on inotropes again. Most believed that providing continuous inotrope therapy for patients with AHF is compatible with the philosophy of hospice care.Cardiac inotropes can align with both the goals of care for the patient with AHF and the philosophy of hospice care. Patients with AHF admitted to hospice care on continuous inotropes may live days to weeks, whether or not inotropes are discontinued.
- Subjects :
- Male
Inotrope
medicine.medical_specialty
Cardiotonic Agents
03 medical and health sciences
0302 clinical medicine
030502 gerontology
Humans
Medicine
Intensive care medicine
Hospice care
Aged
Retrospective Studies
Aged, 80 and over
Heart Failure
business.industry
Symptom management
General Medicine
Middle Aged
medicine.disease
Hospice Care
030220 oncology & carcinogenesis
Heart failure
cardiovascular system
Female
0305 other medical science
business
Subjects
Details
- ISSN :
- 19382715 and 10499091
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- American Journal of Hospice and Palliative Medicine®
- Accession number :
- edsair.doi.dedup.....7ace004e52d6cce34f274c10007efda6