Japanese garden with glowing heart symbolizing palliative care.

Heart Failure in Japan: A Nationwide Call for Palliative Care

Theo Raines in Health & Wellness December 2025 • 4 min read.

"Is Japan ready to embrace palliative care for end-stage heart failure patients?"

Heart failure marks the advanced stage of cardiac disease, a phase where repeated hospitalizations and potential organ damage cast a shadow on patients' lives. While medical advancements aim to improve outcomes and reduce hospital visits, the ultimate goal shifts towards enhancing quality of life, especially as the condition progresses.

In the advanced stages of heart failure, side effects from guideline-recommended treatments, such as hypotension and renal failure, can become limiting factors. Managing symptoms like dyspnea, pain, and delirium gains importance, and palliative care, potentially including morphine, becomes a consideration. These decisions, however, require careful evaluation by a multidisciplinary team.

Traditionally, palliative care is associated with cancer, which creates a gap in understanding and practice among cardiologists and cardiac nurses. This article sheds light on the first nationwide survey conducted in Japan to assess palliative care for heart failure, aiming to enhance care quality and promote specialized, resource-conscious approaches.

Unveiling the Gaps: Key Survey Insights

Japanese garden with glowing heart symbolizing palliative care.

A comprehensive survey was conducted across Japanese Circulation Society-authorized cardiology training hospitals, gathering insights into various aspects of palliative care for heart failure. The survey explored facility characteristics, multidisciplinary team involvement, symptom management, and perceived impediments to providing palliative care.

The survey delved into:

Facility Infrastructure: Basic information about hospitals, including the number of beds and resources available.
Team Dynamics: The composition and roles of multidisciplinary teams in delivering palliative care.
Symptom Management: Approaches to alleviate patient symptoms and improve overall comfort.
Palliative Care Outcomes: Positive outcomes observed following the provision of palliative care services.
Pharmacological Interventions: The role of drug therapy, including morphine, in palliative care for heart failure.
Advance Care Planning: Discussions with patients and families about future care preferences.
Barriers to Care: Obstacles hindering the provision of palliative care for heart failure patients.

The results of the survey underscore the need for clearly defined guidelines for palliative care in heart failure, including team member roles, appropriate medications, and optimal timing for initiating care. By addressing these gaps, the medical community can work towards improving the quality of palliative care and providing more specialized support within existing resource constraints.

Improving Future Palliative Care Strategies

This nationwide survey serves as a crucial first step towards understanding and improving palliative care for heart failure in Japan. Its findings highlight the necessity for comprehensive guidelines that address team composition, drug utilization, and the timing of palliative care initiation.

Early and appropriate advance care planning is essential, as medical interventions can sometimes improve a patient's condition even in severe end-stage heart failure. Engaging patients and their families in open discussions about prognosis and treatment options can greatly enhance the quality of life.

Ultimately, the insights gained from this survey can inform strategies to enhance the quality of palliative care, deliver more specialized support, and optimize resource allocation within the Japanese healthcare system, ensuring that patients with end-stage heart failure receive the comprehensive and compassionate care they deserve.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.jjcc.2017.06.009, Alternate LINK

Title: Design Of A Nationwide Survey On Palliative Care For End-Stage Heart Failure In Japan

Subject: Cardiology and Cardiovascular Medicine

Journal: Journal of Cardiology

Publisher: Elsevier BV

Authors: Yuma Kurozumi, Shogo Oishi, Yasuo Sugano, Akihiro Sakashita, Norihiko Kotooka, Makoto Suzuki, Taiki Higo, Dai Yumino, Yasuko Takada, Seiko Maeda, Saori Yamabe, Koichi Washida, Tomonori Takahashi, Tomohito Ohtani, Yasushi Sakata, Yukihito Sato

Published: 2018-02-01

Everything You Need To Know

What does palliative care involve specifically for end-stage heart failure, and how does it differ from palliative care in other conditions like cancer?

Palliative care in end-stage heart failure focuses on improving the patient's quality of life by managing symptoms such as dyspnea, pain and delirium. It also addresses side effects from guideline-recommended treatments, like hypotension and renal failure, which can become limiting factors in advanced stages. Morphine is a consideration in palliative care. This approach requires careful evaluation by a multidisciplinary team, contrasting with the traditional association of palliative care with cancer.

What key gaps were identified in the provision of palliative care for heart failure based on the nationwide survey in Japan?

The survey highlights several key gaps in palliative care for heart failure in Japan. These include the absence of clearly defined guidelines for palliative care in heart failure, a lack of clarity regarding team member roles, uncertainty about appropriate medications like morphine, and ambiguity concerning the optimal timing for initiating palliative care. Addressing these gaps is essential for improving the quality and specialization of palliative care within existing resource constraints.

What specific aspects of palliative care for heart failure were evaluated in the nationwide survey conducted in Japan?

The survey assessed multiple factors, including facility infrastructure (hospital size and available resources), team dynamics (composition and roles of multidisciplinary teams), symptom management approaches, positive outcomes observed following palliative care, the role of drug therapy (including morphine), advance care planning (discussions about future care preferences), and barriers hindering the provision of palliative care.

What implications does the nationwide survey have for establishing guidelines and standards of care in heart failure?

The nationwide survey revealed a significant need for clearly defined guidelines for palliative care in heart failure. This includes specifying the roles of team members, identifying appropriate medications such as morphine, and determining the optimal timing for initiating palliative care. Establishing these guidelines will help ensure more consistent and effective palliative care for heart failure patients in Japan.

What is 'advance care planning,' and why is it important in the context of palliative care for heart failure?

Advance care planning involves discussions with patients and their families about their preferences for future care. It's a crucial aspect of palliative care, allowing individuals to express their wishes regarding treatment options, symptom management, and end-of-life care. The Japanese survey assessed the extent to which advance care planning is incorporated into palliative care for heart failure patients and identifies it as an important area for improvement.