Aim To assess what is known in the literature regarding the use of subcutaneous furosemide in advanced heart failure, as a foundation for further research.
Background Chronic Heart Failure is a leading cause of morbidity and mortality, and a growing public health problem. If resistance to oral diuretics develops amongst those with end-stage disease, subcutaneous furosemide can be administered for symptom management in community settings, to prevent hospital admission and to honour preferred place of care and death. However, there is a lack of national consensus and use tends to occur in geographical pockets.
Method PubMed, EmCare and HDAS databases were used to look for articles with the key words ‘subcutaneous furosemide’, ‘advanced’, ‘end-stage’, ‘heart failure’, ‘palliative care’ and ‘hospice’. The papers were the thematically analysed and a report compiled.
Results 15 articles were identified through database searches, and a further 3 relevant articles through other means. Just 2 papers involved a randomised controlled trial. All studies referred to the efficacy of the drug administered parenterally and several mentioned the research gap. Other areas addressed included side effects, benefits in community settings and economic implications.
Conclusions/My research idea As further research is required, I aim to develop a research project based on gathering evidence of the experience of health professionals and the efficacy of use of subcutaneous furosemide in end stage heart failure patients locally in the West Midlands. I intend to use an online survey tool.
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