Bringing together
the strengths of
palliative care and
heart failure services
Palliatheartsynthesis
We are a team of researchers from the School of Nursing and Midwifery, Queen’s University Belfast, Nuffield Department of Primary Care Health Sciences, University of Oxford, along with Patient and Public Involvement from the British Heart Foundation London heart failure group. We are all passionate about improving the quality of life of people living with heart failure and their loved ones.
The Research
Why it is important
Heart failure is an illness that mostly affects older people (those over the age of 65), whereby the heart is not able to pump blood sufficiently around the body to meet its needs. People with advanced stages of heart failure can experience frequent and distressing symptoms, negatively impacting their quality of life despite the best medical therapies. These patients would therefore benefit from having palliative care integrated into their everyday heart failure management. Palliative care has traditionally been associated with the care of patients with advanced cancer, but its benefits are increasingly being recognised and used in other chronic or long-term life limiting illnesses, including heart failure. Palliative care can do much to alleviate suffering for people with heart failure as it focuses on adding treatment options that address the physical, psychosocial, and spiritual needs of patients. Thus, improving quality of life for both the patient and their loved ones.
However, integration of palliative care into the management of heart failure remains sparse and problematic. For example, only 7% of people with advanced heart failure are placed on the primary care palliative register in the UK, compared to 48% of those with advanced cancer. Although there is evidence for improved outcomes when palliative care is delivered along with active heart failure management, the available research has reported very different types of care in different settings (e.g. inpatient, outpatient), delivered by different health care professionals (e.g. cardiologists, heart failure nurses, GPs), using different delivery methods (e.g. face-to-face, telemedicine), and involving different components (e.g. symptom management, advance care planning). In summary we know that integrating palliative care for patients with advanced stages of heart failure can benefit them and their carers. But it remains unclear what brings about the best outcomes for patients and their informal carers and this is what this research study will address.
The Plan
Action we will take
For the next stage of the project, we’ve identified five UK sites where integrated palliative and heart failure care is already being delivered. Using a realist approach, we’ll work to understand what’s working well, and what’s not, for different groups of people and in different settings.
We’ll use these insights to co-create a practical ‘how-to’ guide with our clinical partners, patients, and carers. This guide will support other teams across the UK to develop, sustain, and embed integrated care services in their own areas.
To help foster shared learning and support, we’ll also develop a virtual Community of Practice, bringing together professionals who are passionate about integrated palliative and heart failure care. This space will allow them to collaborate, exchange ideas, and grow stronger together as we continue to shape better care for people living with heart failure.
The End Goal
What we aim to achieve
Our findings will be used to provide recommendations on how palliative care and heart failure can be integrated to maximise the potential for widespread implementation, reduce healthcare costs, and improve quality of life for patients and families. We will work closely with our stakeholder group to make sure the findings make sense to them and co-produce a ‘user guide’ that provides practical recommendations for healthcare providers, along with user friendly summaries for the public and patients. With help from our stakeholder group, we will get these out to key audiences (e.g. providers, the public and patients).
Accreditors
We are proud to present
Funders
Supporting us on our journey
This project is funded by the National Institute for Health Research (NIHR) HS&DR (NIHR131800). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
