EAPC Atlas of Palliative Care in Europe 2019

Chapter 10. Integration of Palliative
Care into Cardiology
EUROPEAN CONTEXT
B
TECHNICAL DATA
ON THE 2019 EAPC
SURVEY ON PALLIATIVE
CARE INTO CARDIOLOGY
Population: 54 countries of the
Europe WHO region and Lichtenstein.
Survey Details
Areas explored: 5 indicators
on PC provision in Cardiology
services, inclusion of PC topics
in Cardiology congresses (and
vice versa), meetings between
experts from the national cardiology
and PC associations, and
publications on PC provision in
cardiology services.
Questionnaire: on-line survey,
12 questions, time answered in
(average) 16 minutes.
Participants: 14 national experts
in Palliative Care and Cardiology.
Profile of experts (affiliation):
8 from Cardiology Departments
(5 Cardiology departments, 3
Cardiology Associations), 5 from
PC centres (4 from PC services, 1
from PC Association) and 1 from
University .
Coverage: 12/54 countries
(22%): with one respondent
9/12 (75%) countries, with two
respondents 3/12 (25%)
Data collection: 12/2018 to
3/2019 (4 months)
Project Management: ATLAN-
TES Research Group, Institute for
Culture and Society, University
of Navarra, Pamplona (Navarra),
Spain .
Scientific Advice: Manuel
Martínez Sellés (Spain)
y Pablo Díez Villanueva (Spain).
Promotor: European Association
for Palliative Care (EAPC).
HEART failure patients may have generic palliative care needs and
THEREFORE there exists an increasing conviction that in order to
enhance care for patients with advanced heart diseases, PALLIATIVE
Care should become a usual component.
Nowadays according to the EAPC
dedicated Taskforce on Heart Failure
and the Heart Failure Association
of the European Society of
Cardiology, just a few people with advanced
heart failure and those approaching end of
life, as well as their families, receive appropriate
PC support (1,2). Further existing information
show that large gaps exist in addressing
symptom burden and PC needs of cardiac
patients ( 3,4, 5).
In consequence, this chapter will intend to provide
a view on the degree to which Palliative
Care is integrated into Cardiology in 12 European
countries (Albania, Czech Republic, Denmark,
Germany, Ireland, Italy, Portugal, Spain,
Sweden, Switzerland, The Netherlands and the
United Kingdom) by looking at the very provision
of Palliative Care in cardiology services
but also at the level professional collaboration
between disciplines. In 42 European countries
the research team was unable to identify a reference
person for PC in Cardiology.
PC Provision in Cardiology Services
In Europe, the provision of palliative care for
cardiac patients remains scarce, and solely
eight countries report the existence of pioneering
cardiology services providing Palliative
Care. All these countries (Czech Republic, Denmark,
Ireland, Portugal, Spain, Sweden, The
Netherlands and the United Kingdom) identify
at least an integrated service where often
seems to have dedicated protocols for Palliative
Care delivery (Denmark, Italy, Spain, Netherlands
and United Kingdom).
The frequency with which cardiology services
and PC professionals collaborate is occasional.
A higher ratio has been identified in Spain
and Italy, where good experiences in different
Eduardo Garralda, Manuel Martínez Selllés, Pablo Díez Villanueva.
centres mediated by the oncology experience
(Italy) or a close relationship with intra-hospital
PC teams (Spain), exist.
PC topics inclusion in National
Cardiology Congresses
and vice versa
Palliative care topics have been included at
least in the last three years in 11 European
countries (11/12). The extent to which this is
a common issue varies from country to country.
The Czech Republic reports the inclusion of a
session on Advanced heart failure and palliative
care with four lectures within as an extraordinary
and new achievement, whereas Spain
for instance, report having PC topics included
every year. Similarly, 10 countries (10/12)
report the inclusion of cardiology topics in the
National Palliative Care Congresses in the last
three years though in the perception of some
respondents inclusion of Cardiology topics in
PC Congresses is somehow more difficult than
the other way round. Only Italy and Spain report
the existence of periodical meetings between
experts from the national cardiology and PC
association.
Publications regarding PC
provision in Cardiology Services
Seven countries report the existence of publications
regarding palliative care provision
in cardiology services. The National experts
reported diverse amount of scientific publications
per country, ranging from seven in Spain,
three in the United Kingdom, two in Italy, and
at least one in the Czech Republic, Denmark,
Portugal, and the Netherlands (a sample of
some of these articles can be seen in the bibliographic
references´ section).
EAPC Atlas of Palliative Care in Europe
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