Researchers at the University of Edinburgh compared the experiences of 20 people with lung cancer with those of 20 people with advanced heart failure, using interviews every three months for up to one year with patients, their carers, and key professional carers.

They found that patients with lung cancer had access to good quality written information and most understood their illness and its causes. In contrast, patients with heart failure rarely recalled being given any written information, had a poor understanding of their condition, and had less opportunity to address end of life issues.

More health and social services, including financial benefits were available to those with lung cancer, although they were not always used effectively. Cardiac patients received less health, social, and palliative care, and care was often poorly coordinated.

Many patients with end stage chronic illnesses do not receive appropriate services because their multi-dimensional needs are not understood, and their prognosis is uncertain, say the authors. They argue that all patients with advanced serious illness should be afforded the same priority for palliative care as patients with cancer. Care should be prioritised according to the degree of need the patient has, not simply according to the diagnosis.

Care for patients with advanced heart failure should be proactive and designed to meet their specific needs, they conclude.

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Contact: Emma Dickinson
edickinson@bma.org.uk
44-207-383-6254
BMJ-British Medical Journal
24-Oct-2002