For healthcare professionals
An overview of the CARE-PAC intervention, the evidence base, the work packages, and how to engage as a clinical site or referrer.
The clinical problem
People approaching the end of life experience high symptom burden, frequent crises, and unplanned hospital admissions that often run counter to their preferences. Communication between patients, informal carers, and the multidisciplinary teams supporting them is fragmented across primary, secondary, community, and hospice services. Carer needs are routinely unmet.
CARE-PAC develops and evaluates a digital remote monitoring and support system designed to identify problems early, enhance communication, and enable timely, personalised intervention — alongside structured support for informal carers.
The intervention in outline
The system has three connected components:
- Patient-reported monitoring. Validated symptom and concern assessments delivered through a mobile-friendly interface, with frequency tailored to the patient’s phase of illness.
- Clinical alerting and dashboards. Triaged alerts route to the appropriate clinical team. Trends and unanswered concerns are visible across visits.
- Carer support. A parallel pathway for informal carers, recognising them as both a source of clinical insight and people in need of support themselves.
Where it sits in the care pathway
CARE-PAC is designed to integrate with — not replace — existing palliative and end-of-life care pathways. It augments routine review, supports earlier intervention between contacts, and provides a structured channel for patient and carer voice. The intent is interoperability with existing systems where the local context allows it.
The trial
Following a structured co-production phase, CARE-PAC will be evaluated in a randomised controlled trial across multiple UK clinical sites and settings. Approximately 200 patients near the end of life will take part. Pre-registered outcomes include:
- Patient outcomes: symptom burden, quality of life, healthcare utilisation patterns.
- Carer outcomes: experiences and support needs.
- Implementation outcomes: acceptability, fidelity, and integration into routine practice.
Detailed protocol and statistical plans will be published as the project progresses. See Trial governance for current registration and ethics status.
Work packages
The project is structured around five interlocking work packages:
Co-production & user-centred design
Iterative workshops with patients, carers, and clinicians to shape content, functionality, and integration.
System development
Building the digital platform, with a focus on accessibility, security, and clinical fit.
Randomised controlled trial
Multi-site evaluation across primary, secondary, community, and hospice settings.
Health economics
Cost-effectiveness analysis to support commissioning decisions if the intervention proves effective.
Implementation & commercialisation
Pathways to scale and sustainability, including alignment with regulatory and market requirements.