著者
Yoshiharu Kinugasa Masakazu Saitoh Toshimi Ikegame Aoi Ikarashi Kazushige Kadota Kentaro Kamiya Shun Kohsaka Atsushi Mizuno Isao Miyajima Eisaku Nakane Azusa Nei Tatsuhiro Shibata Hiroyuki Yokoyama Sei Yumikura Dai Yumino Noboru Watanabe Mitsuaki Isobe on behalf of the Research Team for the Provision of Heart Failure Care Centered on General Practitioners in the Community
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-21-0335, (Released:2021-07-07)
参考文献数
32
被引用文献数
10

Background:The purpose of this study was to clarify the current status and issues of community collaboration in heart failure (HF) using a nationwide questionnaire survey.Methods and Results:We conducted a survey among hospital cardiologists and general practitioners (GPs) using a web-based questionnaire developed with the Delphi method, to assess the quality of community collaboration in HF. We received responses from 46 of the 47 prefectures in Japan, including from 281 hospital cardiologists and 145 GPs. The survey included the following characteristics and issues regarding community collaboration. (1) Hospital cardiologists prioritized medical intervention for preventing HF hospitalization and death whereas GPs prioritized supporting the daily living of patients and their families. (2) Hospital cardiologists have not provided information that meets the needs of GPs, and few regions have a community-based system that allows for the sharing of information about patients with HF. (3) In the transition to home care, there are few opportunities for direct communication between hospitals and community staff, and consultation systems are not well developed.Conclusions:The current study clarified the real-world status and issues of community collaboration for HF in Japan, especially the differences in priorities for HF management between hospital cardiologists and GPs. Our data will contribute to the future direction and promotion of community collaboration in HF management.
著者
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
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.82, no.5, pp.1336-1343, 2018-04-25 (Released:2018-04-25)
参考文献数
45
被引用文献数
16 26

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.
著者
Koichiro Kinugawa Yasushi Sakata Minoru Ono Shinichi Nunoda Koichi Toda Norihide Fukushima Akira Shiose Shogo Oishi Dai Yumino Teruhiko Imamura Miyoko Endo Yumiko Hori Koichi Kashiwa Kaoruko Aita Hiroyuki Kojin Yutaka Tejima Yoshiki Sawa
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.85, no.10, pp.1906-1917, 2021-09-24 (Released:2021-09-24)
参考文献数
21
被引用文献数
11

Destination therapy (DT) is the indication to implant a left ventricular assist device (LVAD) in a patient with stage D heart failure who is not a candidate for heart transplantation. The implantable LVAD has been utilized in Japan since 2011 under the indication of bridge to transplant (BTT). After almost 10 year lag, DT has finally been approved and reimbursed in May 2021 in Japan. To initiate the DT program in Japan, revision of the LVAD indication from BTT is necessary. Also, in-depth discussion of caregiver issues as well as end-of-life care is indispensable. For that purpose, we assembled a DT committee of multidisciplinary members in August 2020, and started monthly discussions via web-based communication during the COVID-19 pandemic. This is a summary of the consensus reached after 6 months’ discussion, and we have included as many relevant topics as possible. Clinical application of DT has just started, and we are willing to revise this consensus to meet the forthcoming issues raised during real-world clinical experience.
著者
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
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-17-1305, (Released:2018-03-10)
参考文献数
45
被引用文献数
26

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.