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
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)
(1) Dept. of Radiation-Oncology and Palliative Medicine, KU Leuven, Leuven, Belgium. firstname.lastname@example.org.
(2) Dept. of Radiation-Oncology and Palliative Medicine, University Hospital Gasthuisberg, Leuven, Belgium.
(3) International Observatory on End of Life Care Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK.
(4) Department of Palliative Medicine, University Hospital of Bonn, Bonn, Germany.
(5) Anesthesiology, Pain and Palliative Care, UMC St Radboud, Nijmegen, The Netherlands.
(6) Institute for Culture and Society, University of Navarra, Pamplona, Spain.
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