Publicaciones científicas

Is the Content of Guidelines/Pathways a Barrier for the Integration of Palliative Care in Chronic Heart Failure (CHF) and Chronic Pulmonary Obstructive Disease (COPD)? A Comparison With the Case of Cancer in Europe

28-nov-2017 | Revista: BMC Palliative Care

Naouma Siouta (1), Karen Van Beek (2), Sheila Payne (3), Lukas Radbruch (4), Nancy Preston (3), Jeroen Hasselaar (5), Carlos Centeno (6), Johan Menten (2)


Background: 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 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.

Design: A 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.

Results: The 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.

Conclusion: In 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.

CITA DEL ARTÍCULO  BMC Palliat Care . 2017 Nov 28;16(1):62. doi: 10.1186/s12904-017-0243-7