{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T09:30:09Z","timestamp":1793179809627,"version":"4.5.0"},"reference-count":123,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Patients with heart failure have significant symptom burden, care needs, and often a progressive course to end-stage disease. Palliative care referrals may be helpful but it is currently unclear when patients should be referred and by whom. We conducted a systematic review of the literature to examine referral criteria for palliative care among patients with heart failure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We searched Ovid, MEDLINE, Ovid Embase, and PubMed databases for articles in the English language from the inception of databases to January 17, 2019 related to palliative care referral in patients with heart failure. Two investigators independently reviewed each citation for inclusion and then extracted the referral criteria. Referral criteria were then categorized thematically.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Of the 1199 citations in our initial search, 102 articles were included in the final sample. We identified 18 categories of referral criteria, including 7 needs-based criteria and 10 disease-based criteria. The most commonly discussed criterion was physical or emotional symptoms (n=51 [50%]), followed by cardiac stage (n=46 [45%]), hospital utilization (n=38 [37%]), prognosis (n=37 [36%]), and advanced cardiac therapies (n=36 [35%]). Under cardiac stage, 31 (30%) articles suggested New York Heart Association functional class \u2265III and 12 (12%) recommended New York Heart Association class \u2265IV as cutoffs for referral. Prognosis of \u22641 year was mentioned in 21 (21%) articles as a potential trigger; few other criteria had specific cutoffs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>This systematic review highlighted the lack of consensus regarding referral criteria for the involvement of palliative care in patients with heart failure. Further research is needed to identify appropriate and timely triggers for palliative care referral.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.120.006881","type":"journal-article","created":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T09:04:58Z","timestamp":1599642298000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":75,"title":["Referral Criteria to Palliative Care for Patients With Heart Failure"],"prefix":"10.1161","volume":"13","author":[{"given":"Yuchieh Kathryn","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Palliative Care, Rehabilitation and Integrative Medicine (Y.K.C., H.K., L.M., D.H.), The University of Texas MD Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holland","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Rehabilitation and Integrative Medicine (Y.K.C., H.K., L.M., D.H.), The University of Texas MD Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yimin","family":"Geng","sequence":"additional","affiliation":[{"name":"Research Medical Library (Y.G.), The University of Texas MD Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Mo","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Rehabilitation and Integrative Medicine (Y.K.C., H.K., L.M., D.H.), The University of Texas MD Anderson Cancer Center, Houston, TX."},{"name":"Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China (L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Philip","sequence":"additional","affiliation":[{"name":"Department of Medicine, St Vincent\u2019s Hospital Campus, University of Melbourne, Fitzroy, Australia (J.P., A.C.)."},{"name":"Royal Melbourne Hospital, Parkville, Australia (J.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Medicine, St Vincent\u2019s Hospital Campus, University of Melbourne, Fitzroy, Australia (J.P., A.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry A.","family":"Allen","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine, Aurora (L.A.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"McClung","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Westchester Medical Center, New York Medical College, Valhalla, New York (J.A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin A.","family":"Denvir","sequence":"additional","affiliation":[{"name":"Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom (M.A.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2733-6607","authenticated-orcid":true,"given":"David","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Rehabilitation and Integrative Medicine (Y.K.C., H.K., L.M., D.H.), The University of Texas MD Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12005"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i1010"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00059-017-4677-8"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2018.02.008"},{"key":"e_1_3_4_6_2","unstructured":"World Health Organization. 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