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