Remote Monitoring Instruments in Palliative Care for People With Heart Failure: A Scoping Review

Background: Remote monitoring could improve the management of symptoms, wishes, and needs of patients with heart failure receiving palliative care. However, an overview of existing instruments is lacking, and implementation challenges are poorly understood. Aim: To map and analyze existing instruments used to monitor symptoms, wishes, and needs in heart failure palliative care, and to evaluate their implementation. Design: This scoping review, conducted as part of the HORIZON Europe-funded RAPHAEL project, followed the framework developed by Arksey and O’Malley. Data sources: A systematic search was executed using seven databases (PubMed, Cinahl, Embase, Scopus, PsycINFO, Web of Science, and Medline) on December 11, 2024. Eligible publications focused on remote monitoring of symptoms, wishes, or needs of patients with heart failure in palliative care. Results: Of the 3820 identified studies, 23 met the inclusion criteria, of which 20 were conducted in Western countries. None of the included studies described a monitoring instrument that simultaneously evaluated symptoms, wishes, and needs. Most instruments (n = 22) focused primarily on monitoring physical symptoms and were not specifically designed for palliative care. Only one instrument monitored wishes and needs, but it did not assess symptoms. Details on implementation were often insufficient. Conclusions: Currently no instruments are available that monitor both symptoms as well as identify the wishes and needs of patients with heart failure who receive palliative care. The RAPHAEL project aims to fill this gap by developing an instrument for this purpose whilst assessing its implementation into practice.Registration: Open Science Framework (OSF) (DOI: https://doi.org/10.17605/OSF.IO/5GAFM)