Advance care planning in the treatment of implantable left ventricular assist device: a republication of the review published in Japanese Journal of Artificial Organs

IF 1.1 4区医学 Q4 ENGINEERING, BIOMEDICAL

Journal of Artificial Organs Pub Date : 2024-04-13 DOI:10.1007/s10047-024-01443-1

Yoko Sakamoto, Ryohei Matsuura, Daisuke Yoshioka, Ai Kawamura, Sumiharu Nakamae, Shigeru Miyagawa

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Abstract

Advance care planning (ACP) is essential in managing serious and chronic illnesses to ensure that patients receive care aligned with their personal values, goals, and preferences. This review focuses on integrating ACP in the treatment of patients receiving implantable left ventricular assist devices (VADs). The heart failure palliative care team developed a unique advance directive form and pamphlet to facilitate ACP discussions, emphasizing not only medical treatment preferences but also patients’ values and life goals.

The study highlights the distinction between bridge to transplantation (BTT) and destination therapy (DT) in VAD patients, with different goals and considerations for ACP. The use of decision aids developed especially for DT candidates as a communication tool helps in sharing patients’ wishes and facilitates shared decision-making, particularly in the complex decisions surrounding DT therapy.

Challenges in implementing ACP, such as time constraints due to urgent medical conditions, difficulties in patient communication, and the recent COVID-19 pandemic, are addressed. The need for a comprehensive healthcare system capable of supporting patients’ ACP wishes, especially in the community setting, is also pointed out.

Future directions include not only developing materials to ease ACP discussions and ensuring that ACP content is shared among healthcare providers to foster collaborative and detailed planning, but also a call for widespread adoption of ACP in Japan.

This is a translation of a paper written in Japanese Journal of Artificial Organs (Vol. 52, No. 1, pp. 89–92) with additions and corrections.

Abstract Image

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植入式左心室辅助装置治疗中的预先护理计划：重新发表在《日本人工器官杂志》上的评论文章

预先护理计划 (ACP) 在管理重症和慢性疾病方面至关重要，可确保患者获得符合其个人价值观、目标和偏好的护理。这篇综述的重点是在治疗接受植入式左心室辅助装置（VAD）的患者时整合 ACP。心力衰竭姑息治疗团队开发了一种独特的预嘱表格和小册子，以促进ACP讨论，不仅强调医疗偏好，还强调患者的价值观和生活目标。该研究强调了VAD患者的移植桥（BTT）和终点治疗（DT）之间的区别，两者的目标和ACP考虑因素不同。使用专门为 DT 候选者开发的决策辅助工具作为沟通工具，有助于分享患者的意愿并促进共同决策，尤其是在围绕 DT 治疗的复杂决策中。研究探讨了实施 ACP 所面临的挑战，如紧急医疗状况导致的时间限制、患者沟通困难以及最近的 COVID-19 大流行。未来的发展方向不仅包括开发便于 ACP 讨论的材料，确保 ACP 内容在医疗服务提供者之间共享，以促进合作和详细规划，还包括呼吁在日本广泛采用 ACP。本文是《日本人工器官杂志》（第 52 卷，第 1 期，第 89-92 页）上撰写的论文的译文，有补充和更正。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Artificial Organs 医学-工程：生物医学

CiteScore

2.80

自引率

15.40%

发文量

审稿时长

6-12 weeks

期刊介绍： The aim of the Journal of Artificial Organs is to introduce to colleagues worldwide a broad spectrum of important new achievements in the field of artificial organs, ranging from fundamental research to clinical applications. The scope of the Journal of Artificial Organs encompasses but is not restricted to blood purification, cardiovascular intervention, biomaterials, and artificial metabolic organs. Additionally, the journal will cover technical and industrial innovations. Membership in the Japanese Society for Artificial Organs is not a prerequisite for submission.