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
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.
著者
Yukihito Sato Takashi Kuragaichi Hiroyuki Nakayama Kozo Hotta Yuji Nishimoto Takao Kato Ryoji Taniguchi Koichi Washida
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-22-0675, (Released:2022-12-23)
参考文献数
81
被引用文献数
3

The Japanese population is rapidly aging because of its long life expectancy and low birth rate; additionally, the number of patients with heart failure (HF) is increasing to the extent that HF is now considered a pandemic. According to a recent HF registry study, Japanese patients with HF have both medical and care-related problems. Although hospitalization is used to provide medical services, and institutionalization is used to provide care for frail older adults, it can be difficult to distinguish between them. In this context, multidisciplinary management of HF has become increasingly important in preventing hospital readmissions and maintaining a patient’s quality of life. Academia has promoted an increase in the number of certified HF nurses and educators. Researchers have issued numerous guidelines or statements on topics such as cardiac rehabilitation, nutrition, and palliative care, in addition to the diagnosis and treatment of acute and chronic HF. Moreover, the Japanese government has created incentives through various medical and long-term care systems adjustments to increase collaboration between these two fields. This review summarizes current epidemiological registries that focus not only on medical but also care-related problems and the 10 years of multidisciplinary management experience in Japanese medical and long-term care systems.