Indicators of palliative care integration in heart failure: a Delphi study




Miguel A. Sánchez-Cárdenas, Facultad de Enfermería, Universidad El Bosque, Bogotá, Colombia
Ana L. Ribero-Ocampo, Facultad de Enfermería, Universidad El Bosque, Bogotá, Colombia
Angélica Ma. Morales-Rivera, Facultad de Enfermería, Universidad El Bosque, Bogotá, Colombia
Angie L. Cañón-Rodríguez, Facultad de Enfermería, Universidad El Bosque, Bogotá, Colombia
Gabriela B. Gutiérrez-Ladino, Facultad de Enfermería, Universidad El Bosque, Bogotá, Colombia
Laura C. Bolívar-Escarraga, Facultad de Enfermería, Universidad El Bosque, Bogotá, Colombia
Laura Ma. Olarte-Olarte, Facultad de Enfermería, Universidad El Bosque, Bogotá, Colombia
Luz A. Willamil-Ballen, Facultad de Enfermería, Universidad El Bosque, Bogotá, Colombia
Laura González-Salazar, Facultad de Medicina, Universidad de La Sabana, Bogotá, Colombia
Genny P. Fuentes-Bermúdez, Facultad de Enfermería, Universidad Nacional de Colombia, Bogotá, ColombiaBogotá, Colombia


Introduction: Heart failure, a disease with high prevalence and mortality, presents low incorporation of palliative care (PC) despite its necessity. In Colombia, the lack of indicators to monitor the integration of PC in the treatment of heart failure hinders the implementation of effective strategies. It is proposed to use a classification model to monitor the integration of palliative care in the Colombian health system. Objective: To reach a consensus on a set of indicators evaluated for their relevance and feasibility to monitor the integration of palliative care in heart failure in the Colombian health system. Method: A Delphi consensus process was carried out in two rounds, including experts from different regions of the country. An online survey was used on nine indicators related to the integration of palliative care in heart failure in the Colombian health system. Each indicator was evaluated for its relevance and feasibility. Results: Seventeen experts from all regions of Colombia participated, 76% were physicians and 24% nursing professionals; the vast majority (65%) belonged to scientific societies such as the Colombian Association of Palliative Care. All the indicators scored > 7.0 with respect to their relevance and feasibility. The Advance directives in people with heart failure indicator was considered the most relevant and feasible followed by home palliative care for people with heart failure. Conclusions: Based on feasibility and relevance there was consensus on eight of the nine indicators proposed to evaluate the integration of palliative care in the treatment of heart failure in Colombia.



Keywords: Palliative care. Heart failure. Indicators. Delphi technique. Consensus.




Revista Colombiana de Cardiología