IAHPC list of essential practices in palliative care

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Background The World Health Organization advocates that palliative care should be integrated in healthcare policies and programs. Yet the vast majority of the world’s population does not have access to palliative care. Studies also suggest that most people with advanced illnesses prefer to be cared for at home or near their home but most people die in institutions or, if at home, without the appropriate care. These, plus several limitations, call for the identification of priorities in the delivery of primary palliative care, so that the healthcare providers are able to meet the most pressing needs of patients with advanced life-limiting conditions, and those of their families. Under this framework, the International Association for Hospice and Palliative Care (IAHPC) decided, several years ago, to work on several projects aimed at identifying ‘essential’ components for optimal palliative care provision. The IAHPC recently completed a project to identify the list of essential practices in palliative care. This follows the IAHPC List of Essential Medicines in Palliative Care and the Opioid Essential Prescription Package developed in 2007 and 2011, respectively. The objective of this project was to identify, through a consensus process, the essential practices in palliative care which could be provided by physicians, nurses, and nurse aides working at the primary care level and could be applicable in all socioeconomic settings. The list of essential practices in palliative care for health workers working in primary care includes those practices aimed at meeting the most prevalent physical, social, psychological, and spiritual needs of palliative care patients and their families. To work on this project, the IAHPC convened a working group (WG) which included board members and external advisors from the field. The members of the WG for this project were Michael I. Bennett (UK), Eduardo Bruera (USA), Liliana De Lima (USA), Derek Doyle (UK), Julia Downing (Uganda), Clara Granda-Cameron (USA), Peter Hudson (Australia), Scott Murray (UK), Florian Strasser (Switzerland), and Roberto Wenk (Argentina). Additional advice, recommendations, and comments were provided by Gian Domenico Borasio (Switzerland), David Currow (Australia), Frank Ferris (USA), Faith Mwangi-Powell (Uganda), and M. R. Rajagopal (India). This paper describes the summary of the process to develop such a list. A three-phase study was designed and implemented over two and a half years. The phases included the development of a baseline list, a Delphi process with participants from more than 60 countries, and the participation of representatives from 45 palliative care organizations. A document which comprehensively outlines the methodology and the results is available in the IAHPC website under the ‘Palliative Care Essentials’ icon (www.hospi cecare.com) As the holder of the copyright, the IAHPC allows free dissemination for educational purposes providing appropriate acknowledgment to the organization is given.