1.4% of the UK population are living with heart failure, and the management of symptoms such as breathlessness and swelling can become more problematic in the end stages of this disease. Administration of Subcutaneous Furosemide (SCF), can provide significant relief and its use is increasing within the field of palliative care.
Following a literature review and a pilot survey, an online survey was sent to clinicians working in palliative care within the West Midlands, assessing experience and confidence in using SCF, as well as advantages and barriers to use.
We had 36 responders, 89% working within specialist palliative care and 78% having administered or prescribed SCF.
81% stated that using SCF had resulted in avoidance of hospital admission. 72% felt that SCF had provided effective symptom relief.
Other advantages described included facilitating care in the community, enabling diuretic use when the oral route was no longer available, and overcoming absorption limitations.
Drawbacks listed included logistical and volume issues with syringe drivers, site reactions, the burden of continuous therapy, and lack of familiarity with SCF.
Participant confidence level with prescribing SCF was 62/100 and there was a wide variation in monitoring after commencing SCF.
This study shows that SCF administration in end stage heart failure is occuring frequently within the region, and is improving patient symptom burden and preventing hospital admission. Notably, confidence in prescribing SCF needs improvement, which could be addressed through increased training, as well as further research into how to optimise, deliver and monitor SCF therapy.