Abstract
Context
Physicians who specialize in pulmonary arterial hypertension (PAH) care for patients
facing a serious, life-limiting illness. Palliative care is underutilized in patients
with PAH, and little is known about how best to provide palliative care to this patient
population.
Objectives
Using a qualitative approach, assess physicians’ perspectives on barriers and facilitators
to the use of palliative care in PAH.
Methods
Participants were board-certified pulmonologists and cardiologists recruited from
the Pulmonary Hypertension Association's list of physician specialists and academic
center websites. We performed one-on-one semi-structured interviews that were recorded,
transcribed, and analyzed using thematic analysis.
Results
Twelve physicians participated in the study, with a median age of 48.5 years and 20.5
years of clinical experience caring for patients with PAH. We identified the following
themes and associated barriers and facilitators to effective implementation of palliative
care for patients with PAH: a tailored approach to the individual patient; a PAH-specialist-led
culture of care; effective collaboration with palliative care clinicians; and limitations
imposed by health systems.
Conclusion
PAH physicians are open to palliative care for their patients and are willing to partner
with palliative care clinicians to implement this effectively and in the right setting.
Areas for targeted improvement in enhancing palliative care for patients with PAH
exist, especially enhancing collaboration between PAH physicians and palliative care
specialists and navigating barriers in health systems.
Key Words
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Article info
Publication history
Published online: December 12, 2022
Accepted:
November 29,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
