Palliative care in heart failure: facts and numbers

Millions of people worldwide have heart failure. Despite enormous advances in care that have improved outcome, heart failure remains associated with a poor prognosis. Worldwide, there is poor short‐term and long‐term survival. The 1 year survival following a heart failure admission is in the range of 20–40% with between‐country variation. For those living with heart failure, the symptom burden is high. Studies report that 55 to 95% of patients experience shortness of breath and 63 to 93% experience tiredness. These symptoms are associated with a high level of distress (43–89%). Fewer patients experience symptoms such as constipation (25–30%) or dry mouth (35–74%). However, when they do, such symptoms are associated with high levels of distress (constipation: 15–39%; dry mouth: 14–33%). Psychological symptoms also predominate with possibly as many as 50% experiencing depression. Palliative care services in heart failure are not widely available. Even in countries with well‐developed services, only around 4% of patients are referred for specialist palliative care. Many patients and their families would benefit from receiving specialist palliative care support.