{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T03:41:33Z","timestamp":1791258093048,"version":"4.1.0"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":142,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"crossref","award":["101137170"],"award-info":[{"award-number":["101137170"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Heart failure (HF) is a growing health and societal challenge in Europe, due to an increasingly elderly, frail and multimorbid population. Many patients with HF experience a high burden of complex and multidimensional symptoms leading to a reduced quality of life and significant socioeconomic impact. Despite proven benefits, the integration of palliative care into HF management pathways remains inconsistent and underutilized. We aim to map how current national and international guidelines recommend integrating palliative care into HF management across the 10 countries represented by the EU-funded RAPHAEL consortium (Horizon Europe programme, No 101137170): Belgium, Germany, Lithuania, the Netherlands, Spain, Italy, Poland, Sweden, Switzerland and the United Kingdom. A systematic search was conducted across six databases (EMBASE, Global Health, MEDLINE, PsycINFO, The Cochrane Library and Web of Science) for publications from 1 January 2000 to 25 May 2024. Eligible publications focused on adults with HF and models of palliative care integration. Data were synthesized using content analysis. Of 1543 records screened, 13 publications were included. Most studies were guidelines, consensus or position papers; only one was qualitative research. The definition of the population with HF eligible for palliative care was heterogeneous and inconsistently defined, mostly by symptoms (4\/13 publications; 31%) and pathophysiology (2\/13; 15%). The most frequent triggers for palliative care referral were clinical features and symptoms (8\/13; 62%), patients approaching the end of life (8\/13; 62%), and symptomatic deterioration despite optimal therapy (7\/13; 54%). Additional triggers included multiple (&amp;gt;1) unplanned hospitalizations (6\/13; 46%) and spiritual, emotional or social issues (7\/13; 54%). Outcomes of palliative care referral for HF patients focused on quality of life (9\/13; 69%) and symptom control (9\/13; 69%). Multiprofessional involvement was emphasized with cardiologists (12\/13; 92%), nurses (10\/12; 77%), palliative care specialists (9\/13; 69%) and primary care physicians (4\/13; 31%). Publications generally noted that despite increased awareness and recommendations, referrals remain low and mostly late stages. This review underscores the need for structured, early integration of palliative care in HF management across Europe with clear triggers for palliative care referral, application of standardized pathways and fostering of multiprofessional collaboration. Developing these, while simultaneously addressing implementation challenges through policy development, could improve patient outcomes and quality of life.<\/jats:p>","DOI":"10.1002\/ehf2.15431","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T09:11:24Z","timestamp":1759137084000},"page":"4021-4032","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Mapping of Current Practices of Palliative Care for Patients with Heart Failure Throughout Europe: A Scoping Review"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1294-9657","authenticated-orcid":false,"given":"Tania","family":"Pastrana","sequence":"first","affiliation":[{"name":"Department of Palliative Medicine, Uniklinik RWTH Aachen , Aachen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6878-9197","authenticated-orcid":false,"given":"Matthew","family":"Grant","sequence":"additional","affiliation":[{"name":"Department of General Practice and Nursing Science, Julius Center of Primary Care and Health Sciences, University Medical Center Utrecht , Utrecht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1797-3258","authenticated-orcid":false,"given":"Paula Hidalgo","family":"Andrade","sequence":"additional","affiliation":[{"name":"Universidad de Las Am\u00e9ricas , Quito ,","place":["Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1527-2118","authenticated-orcid":false,"given":"Daniele","family":"Marelli","sequence":"additional","affiliation":[{"name":"Palliative Medicine, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7146-7105","authenticated-orcid":false,"given":"Klaus","family":"Witte","sequence":"additional","affiliation":[{"name":"Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds , Leeds ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6976-9844","authenticated-orcid":false,"given":"Geert-Jan","family":"Geersing","sequence":"additional","affiliation":[{"name":"Department of General Practice and Nursing Science, Julius Center of Primary Care and Health Sciences, University Medical Center Utrecht , Utrecht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5495-5054","authenticated-orcid":false,"given":"Carla","family":"Ripamonti","sequence":"additional","affiliation":[{"name":"Palliative Medicine, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7370-8574","authenticated-orcid":false,"given":"Roman","family":"Rolke","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Uniklinik RWTH Aachen , Aachen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6691-8568","authenticated-orcid":false,"given":"Marco","family":"Metra","sequence":"additional","affiliation":[{"name":"Cardiology. ASST Spedali Civili. Department of Medical and Surgical Specialties, radiological sciences and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9298-7871","authenticated-orcid":false,"given":"Matteo","family":"Pagnesi","sequence":"additional","affiliation":[{"name":"Cardiology. ASST Spedali Civili. Department of Medical and Surgical Specialties, radiological sciences and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8528-4070","authenticated-orcid":false,"given":"Everlien","family":"De Graaf","sequence":"additional","affiliation":[{"name":"Department of General Practice and Nursing Science, Julius Center of Primary Care and Health Sciences, University Medical Center Utrecht , Utrecht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5156-8638","authenticated-orcid":false,"given":"Cosimo","family":"Chelazzi","sequence":"additional","affiliation":[{"name":"Palliative Medicine, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia , Brescia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"RAPHAEL consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"2026021804203490100_ehf215431-bib-0001","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1177\/10499091231154575","article-title":"End-of-life care for patients with end-stage heart failure, comparisons of international guidelines","volume":"41","author":"Rivera","year":"2024","journal-title":"Am J Hosp Palliat Care"},{"key":"2026021804203490100_ehf215431-bib-0002","doi-asserted-by":"publisher","first-page":"3272","DOI":"10.1093\/cvr\/cvac013","article-title":"Global burden of heart failure: a comprehensive and updated review of epidemiology","volume":"118","author":"Savarese","year":"2023","journal-title":"Cardiovasc Res"},{"key":"2026021804203490100_ehf215431-bib-0003","doi-asserted-by":"crossref","first-page":"5","DOI":"10.21037\/amj.2020.03.03","article-title":"Global epidemiology and future trends of heart failure","volume":"5","author":"Lippi","year":"2020","journal-title":"AME Med J"},{"key":"2026021804203490100_ehf215431-bib-0004","doi-asserted-by":"publisher","first-page":"2193","DOI":"10.1002\/ehf2.12875","article-title":"Prioritizing symptom management in the treatment of chronic heart failure","volume":"7","author":"Koshy","year":"2020","journal-title":"ESC Heart Fail"},{"key":"2026021804203490100_ehf215431-bib-0005","doi-asserted-by":"publisher","first-page":"2767","DOI":"10.1002\/ehf2.14076","article-title":"Impact analysis of heart failure across European countries: an ESC-HFA position paper","volume":"9","author":"Rosano","year":"2022","journal-title":"ESC Heart Fail"},{"key":"2026021804203490100_ehf215431-bib-0006","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1016\/j.jpainsymman.2020.04.027","article-title":"Redefining palliative care-a new consensus-based definition","volume":"60","author":"Radbruch","year":"2020","journal-title":"J Pain Symptom Manage"},{"key":"2026021804203490100_ehf215431-bib-0007","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.310.6982.805","article-title":"Palliative care in terminal cardiac failure","volume":"310","author":"Jones","year":"1995","journal-title":"BMJ"},{"key":"2026021804203490100_ehf215431-bib-0008","volume-title":"National service framework for coronary heart disease","author":"Department of Health","year":"2000"},{"key":"2026021804203490100_ehf215431-bib-0009","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1016\/j.ejheart.2008.08.005","article-title":"ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the task force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology. 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