“I Just Feel Like I Always Did”: Inotropic Dependency at End of Life

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Patients not considered for mechanical circulatory support or heart transplant may be dependent on inotropic therapy at end of life. End-of-life conversations in advanced heart failure can be challenging for providers, but guidelines recommend frequent goals-of-care conversations when inotropes are used as a palliative treatment. The purpose of this study was to identify aspects of care pertinent for health-care professionals working with patients in end-stage heart failure who are receiving continuous inotropic support. Methods: Qualitative analysis was used to examine 3 audio-recorded semistructured interviews with 1 patient, her family, and her cardiologist. The selected patient was an older adult, diagnosed with advanced heart failure, and dependent on continuous inotropic therapy with no other advanced treatment options available. Results: The analysis revealed that (1) reliance on others, (2) contending with uncertainty, and (3) deciding when to discontinue inotropic support were identified as themes central to the patient’s and provider’s experience. Conclusion: This study offers insight into how to best support and communicate with patients having advanced heart failure who are dependent on continuous inotropic therapy at end of life.

Original languageEnglish
Pages (from-to)497-502
Number of pages6
JournalAmerican Journal of Hospice and Palliative Medicine
Volume37
Issue number7
DOIs
StatePublished - Jul 1 2020

Bibliographical note

Publisher Copyright:
© The Author(s) 2019.

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

Keywords

  • end of life
  • heart failure
  • hospice
  • inotropic therapy
  • palliative care
  • qualitative

ASJC Scopus subject areas

  • Medicine (all)

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