RAPHAEL - Integrating a Palliative Care Approach for Patients with Heart Failure

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While the need for integrating palliative care (PC) services into heart failure (HF) care has been well recognised, as of yet this integrationlacks behind, especially when compared to cancer care. Currently, only 5-7% of patients with HF utilise PC services, due to a focus onoptimising therapy and an unpredictable disease trajectory with exacerbations which hampers prognosis. As a result, many symptomsand concerns that are not directly related to HF are not recognised and undertreated and patients are often referred to PC services only atthe very end of their lives. The RAPHAEL consortium sets out to take the next big step in integrating PC into HF care by integrating theRAPHAEL palliative care approach in existing HF care pathways. This flexible and patient centred approach starts with the identificationof multidimensional symptoms and concerns, prioritise needs with patient and informal carer and formulate a proactive care plan. Thesymptoms and concerns will be monitored by the patient at home using the PAL@HEART application. The app can be used to evaluateinterventions, support communication and earl identify new or increasing needs. As a result, the care needs of each individual patient withHF are addressed faster and better, improving their quality of life and autonomy. Moreover, this will lead to a reduction in emergencyhospitalisations, unburdening the healthcare system and reducing costs. The RAPHAEL project sets out to adapt the RAPHAEL approachto HF care within a European context and test and validate its (cost-)effectiveness via a feasibility and large-scale evaluation studyperformed in 7 EU countries, the UK and Switzerland. It brings together experts in palliative care, cardiology, and primary care as wellas professional organisations and patient representatives. Together the RAPHAEL consortium is uniquely situated to demonstrate the(cost-)effectiveness of the RAPAHEL approach and launch its implementation in Europe and beyond.