Palliative care in chronic heart failure in the Netherlands: practices, competencies and barriers among hospital-based healthcare professionals

Abstract Background Although proven beneficial, palliative care (PC) and advance care planning (ACP) for patients with chronic heart failure (HF) are still underexposed. This study aimed to (1) explore current practices of hospital-based healthcare professionals (HCPs) regarding PC and ACP in chronic HF, (2) assess their competencies, and (3) identify barriers to integrate PC and ACP into routine chronic HF care in the Netherlands. Methods A task force of the Netherlands Society of Cardiology developed an online survey using Qualtrics. The survey was distributed among HCPs involved in the care of patients with chronic HF by the Netherlands Society of Cardiology and the Dutch Society of Cardiovascular Nurses to contacts, and through social media channels between February and March 2022. Results 120 HCPs (cardiologists (49%), nurses and nurse practitioners (40%), and allied professionals (11%)) completed the survey. 97% of HCPs found PC and ACP for patients with chronic HF (very) important, yet only about one third providing such care regularly. While 78% reported being able to recognize PC needs, only 23% felt sufficiently skilled providing PC. Reported priorities for improvement included ACP, recognition of PC needs, interprofessional collaboration, communication with patients and significant others, and sufficient time to provide PC and ACP. Conclusions HCPs acknowledge the importance of PC and ACP in chronic HF, but integration into routine practice remains limited. Barriers are lack of skills and time constraints. There is a need for education and appropriate organization of PC and ACP for patients with chronic HF in the Netherlands.