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

BMC Palliative Care

Research Article

Jeroen Hasselaar¹  Lukas Radbruch²  Naouma Siouta³  Johan Menten⁴  Karen Van Beek⁴  Carlos Centeno⁵  Sheila Payne⁶  Nancy Preston⁶ 

[1] Anesthesiology, Pain and Palliative Care, UMC St Radboud, Nijmegen, The Netherlands;Department of Palliative Medicine, University Hospital of Bonn, Bonn, Germany;Dept. of Radiation-Oncology and Palliative Medicine, KU Leuven, Leuven, Belgium;Dept. of Radiation-Oncology and Palliative Medicine, University Hospital Gasthuisberg, Leuven, Belgium;Institute for Culture and Society, University of Navarra, Pamplona, Spain;International Observatory on End of Life Care Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK;

关键词: Care;    Palliative;    Delivery of health care;    Integrated;    Medical oncology;    Heart failure;    Chronic obstructive pulmonary disease;   

DOI  :  10.1186/s12904-017-0243-7

 received in 2017-06-23, accepted in 2017-11-14,  发布年份 2017

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY   
© The Author(s). 2017