Abstract
BackgroundThere is a notable inequity in access to palliative care (PC) services between cancer and Chronic Heart Failure (CHF)/Chronic Obstructive Pulmonary Disease (COPD) patients which also translates into discrepancies in the level of integration of PC. By cross-examining the levels of PC integration in published guidelines/pathways for CHF/COPD and cancer in Europe, this study examines whether these discrepancies may be attributed to the content of the guidelines.DesignA quantitative evaluation was made between integrated PC in published guidelines for cancer and CHF/COPD in Europe. The content of integrated PC in guidelines/pathways was measured using an 11 point integrated PC criteria tool (IPC criteria). A statistical analysis was carried out to detect similarities and differences in the level of integrated PC between the two groups.ResultsThe levels of integration between CHF/COPD and cancer guidelines/pathways have been shown to be statistically similar. Moreover, the quality of evidence utilized and the date of development of the guidelines/pathways appear not to impact upon the PC integration in the guidelines.ConclusionIn Europe, the empirically observed imbalance in integration of PC for patients with cancer and CHF/COPD may only partially be attributed to the content of the guidelines/pathways that are utilized for the PC implementation. Given the similarities detected between cancer and CHF/COPD, other barriers appear to play a more prominent role.
Highlights
There is a notable inequity in access to palliative care (PC) services between cancer and Chronic Heart Failure (CHF)/Chronic Obstructive Pulmonary Disease (COPD) patients which translates into discrepancies in the level of integration of PC
The number of cancer guidelines was over thrice as high as the one for CHF/COPD (74 vs 19)
Our analysis reveals that, at least statistically, there is no difference between the levels of integration of PC in the content of the guidelines/pathways for cancer and CHF/ COPD
Summary
There is a notable inequity in access to palliative care (PC) services between cancer and Chronic Heart Failure (CHF)/Chronic Obstructive Pulmonary Disease (COPD) patients which translates into discrepancies in the level of integration of PC. Integrated PC involves bringing together administrative, organisational, clinical and service aspects in order to achieve continuity of care between all those involved in the patient’s care network. It aims to achieve quality of life and a well-supported dying process for the patient and the family in collaboration with all the care givers (paid and unpaid) [3,4,5,6]. There is evidence-based consensus that integrated PC results in the improvement of the quality of life of patients with both malignant and non-malignant diseases [7,8,9,10,11,12,13,14,15,16,17,18,19,20,21]
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