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Nursing issues
Using advance care planning for end-of-life care in heart failure improves outcomes
  1. Karol Harshaw-Ellis
  1. Duke University, Durham, North Carolina, USA
  1. Correspondence to Dr Karol Harshaw-Ellis, Duke University, Durham, NC 27708, USA; karol.harshawellis{at}

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Commentary on: Schichtel M, Wee B, Perera R, Onakpoya I. The effect of advance care planning on heart failure: a systematic review and meta-analysis. J Gen Internal Med 2019. Epub ahead of print 12 November.

Implications for practice and research

  • Nurses are well equipped to have key roles in facilitating advanced care planning (ACP) for patients and families.

  • Future research of ACP in heart failure (HF) should encompass multiple key components and multidisciplinary teams emphasising ethnic preferences to shift the paradigm of HF end-of-life care.


Heart failure (HF) is a chronic, progressive condition with tremendous burden on healthcare, patients and families. Six million Americans live with HF, projected to be eight million by 2030.¹ Despite medical developments, HF mortality remains 50% 5 years after diagnosis.² As HF progresses, patients, providers and families experience more suffering and symptom burden, impairing quality of life more …

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  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.