National Strategy for Integrating Palliative Care into Standard Cardiac Care for People Living with Heart Failure: a Position Statement from the Joint Working Group of the Swiss Societies of Cardiology and Palliative Care. Published with endorsement of the Swiss Society of Cardiology and the Swiss Society for Palliative Care

Piotr Z. Sobanski ^1,2* Maria Luisa De Perna ³ Sandra Eckstein ⁴ Tanja Fusi-Schmidhauser ^5,6 Jan Gaertner ^7,8 Valentina Gonzalez Jaramillo ⁹ Lisa Hentsch ¹⁰ Caroline Hertler ¹¹ Roger Hullin ¹² Lukas Hunziker ¹³ Jean-Baptiste Mercoli ¹⁴ Philippe Meyer ¹⁵ Giorgio Moschovitis ³ Matthias Paul ¹⁶ Philip Larkin ¹⁷ Otmar Pfister ¹⁸

• ¹ Palliative Care Unit, Department of Internal Medicine, Schwyz Hospital, Schwyz, Switzerland
• ² 1. Department of Cardiology, Medical University of Gdansk, Gdańsk, Pomeranian, Poland
• ³ Servizio di Cardiologia, Istituto Cardiocentro Ticino, Ospedale Regionale di Lugano, Lugano, Ticino, Switzerland
• ⁴ Division of Palliative Care, Department Theragnostic, University Hospital of Basel, Basel, Basel-Stadt, Switzerland
• ⁵ Clinica di Cure Palliative e di Supporto, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
• ⁶ Département de Réadaptation et Gériatrie, Centre Médical Universitaire, Université de Genève, Geneva, Geneva, Switzerland
• ⁷ Department of Clinical Research, University of Basel, Basel, Switzerland
• ⁸ Center for Palliative Care Basel, Basel, Switzerland
• ⁹ University Center for Palliative Care, Inselspital University Hospital Bern, Bern, Bern, Switzerland
• ¹⁰ Division of Palliative Care, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Geneva, Geneva, Switzerland
• ¹¹ Kompetenzzentrum Palliative Care, Klinik für Radioonkologie, University Hospital Zürich, Zurich, Zürich, Switzerland
• ¹² Service de Cardiologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Vaud, Switzerland
• ¹³ Department of Cardiology, University Hospital of Bern, Bern, Bern, Switzerland
• ¹⁴ Gruppo Ospedaliero Moncucco, Lugano, Switzerland
• ¹⁵ Cardiology Service, University Hospitals of Geneva, Geneva, Geneva, Switzerland
• ¹⁶ Herzzentrum, Luzerner Kantonsspital, Lucerne, Switzerland
• ¹⁷ haire Kristian Gerhard Jebsen de Soins Palliatifs Infirmiers, Universite de Lausanne,, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Vaud, Switzerland
• ¹⁸ Department of Cardiology, University Hospital of Basel, Basel, Basel-Stadt, Switzerland

Heart failure (HF) causes high symptom burden and shortens life expectancy. Implementation of Palliative Care (PC) concurrently with cardiologic guidelines-directed medical therapy (GDMT) improves quality-of-life (QoL) more than disease-oriented management alone but is underused. To facilitate provision of PC for people living with HF, the Swiss Society of Cardiology (SSC) and the Swiss Society for Palliative Care (palliative.ch) has created joint working-group.Dyads representing cardiology and PC from Swiss HF centres have been identified. Through online voting, workshops and Delphi process priority topics for incorporation of PC into standard care for people with HF have been identified.18 experts, from 8 Swiss HF-centres identified main topics relevant for implementation of PC in usual HF care: timely recognition of unaddressed health-related needs of affected people and their relatives (using validated assessment tools ID-PALL or NAT-PD:CH at least as the triggers evolve), identifying key palliative interventions for care of people living with HF, identifying strategies to facilitate cooperation between specialist PC and cardiology, defining research agenda to investigate efficacy of PC interventions, quality of care criteria, and outcomes of PC provision in Switzerland.Improvement of QoL people with HF and their relatives could be greater if PC would be integrated in usual care timely. Frequent needs assessment, using validated tools helps to recognize people having unaddressed needs, and helps to replace the outdated, based on risk of dying, involvement of PC. Dialogue between both disciplines is crucial to provide care prolonging life of best quality during the whole journey living with disease.