Key result
Integrating rehabilitation and palliative care in HF lacks empirical evidence despite widespread support.
Why the study?
Rehabilitation and palliative care are traditionally delivered separately, but there is growing recognition of the potential benefit of integrating these approaches for heart failure, COPD, and interstitial lung disease.
How is the integration or coordination of rehabilitation and palliative care described in the literature for patients with severe lung disease or heart failure?
How is the integration or coordination of rehabilitation and palliative care described in the literature for patients with severe lung disease or heart failure?
While there is broad consensus that integrating rehabilitation and palliative care could improve quality of life for patients with severe lung disease or heart failure, practical implementation and interventional evidence remain limited.
Supports multidisciplinary symptom management in advanced HF; leaves open the optimal implementation strategy, requiring prospective.
Traditionally, rehabilitation and palliative care are delivered as separate services, where rehabilitation focuses on regaining physical functions and palliative care on symptom relief and existential support. There is growing recognition of the potential benefit in integrating these approaches. This scoping review explores how integration or coordination of rehabilitation and palliative care is described in the literature, with a focus on heart failure, chronic obstructive pulmonary disease, and interstitial lung disease. A systematic search was conducted in MEDLINE, EMBASE, and CINAHL, identifying 20 relevant publications. Six overarching themes emerged: overlapping treatment goals; timing of services; inclusion of advance care planning (ACP); attention to existential and spiritual dimensions; barriers to integration; and the role of informal caregivers. The majority of the included studies were re-views or expert statements, with few interventional studies. Practical implementation remains limited and poorly defined. While guidelines increasingly support integrated care models, significant challenges persist, including lack of conceptual clarity, limited evidence of effect, and unclear roles for caregivers. There is broad consensus that integration could improve quality of life for both patients and caregivers by combining the functional focus of rehabilitation with palliative symptom management and its holistic approach. While publications support this integration, its implementation in clinical practice remains unclear. A key argument for integration is the overlap in treatment goals and the potential synergy between the two approaches. Several studies highlight the opportunity to incorporate end-of-life discussions, such as ACP, into traditional rehabilitation programs. Introducing palliative care principles earlier in rehabilitation may also increase the number of patients receiving appropriate end-of-life care.
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Marsaa et al. (2025) conducted a review in Severe lung disease (COPD, ILD) or heart failure (n=20). Integration of rehabilitation and palliative care was evaluated. Integration of rehabilitation and palliative care for severe lung disease or heart failure is widely supported to improve quality of life, though empirical interventional evidence remains limited.
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