TY - JOUR
T1 - Redefining Palliative Care—A New Consensus-Based Definition
AU - Radbruch, Lukas
AU - De Lima, Liliana
AU - Knaul, Felicia
AU - Wenk, Roberto
AU - Ali, Zipporah
AU - Bhatnaghar, Sushma
AU - Blanchard, Charmaine
AU - Bruera, Eduardo
AU - Buitrago, Rosa
AU - Burla, Claudia
AU - Callaway, Mary
AU - Munyoro, Esther Cege
AU - Centeno, Carlos
AU - Cleary, Jim
AU - Connor, Stephen
AU - Davaasuren, Odontuya
AU - Downing, Julia
AU - Foley, Kathleen
AU - Goh, Cynthia
AU - Gomez-Garcia, Wendy
AU - Harding, Richard
AU - Khan, Quach T.
AU - Larkin, Phillippe
AU - Leng, Mhoira
AU - Luyirika, Emmanuel
AU - Marston, Joan
AU - Moine, Sebastien
AU - Osman, Hibah
AU - Pettus, Katherine
AU - Puchalski, Christina
AU - Rajagopal, M. R.
AU - Spence, Dingle
AU - Spruijt, Odette
AU - Venkateswaran, Chitra
AU - Wee, Bee
AU - Woodruff, Roger
AU - Yong, Jinsun
AU - Pastrana, Tania
N1 - Funding Information:
A portion of the salary of L. D. L. was covered by a core support grant, IAHPC Core Support, from the U.S. Cancer Pain Relief Committee and the grant Advancing palliative care through advocacy for policy changes from Open Society Foundations (grant number: OR2018-41903 ).
Funding Information:
The map on Fig. 1 was prepared by Dr. Juan Jose Pons, from the ATLANTES research group at the University of Navarra. The authors are very grateful with the 412 IAHPC members who accepted their invitation to participate in Phase 2 of this project. The participants and their country of residence are included in Table 2. This research received no specific funding/grant from any funding agency in the public, commercial, or not-for-profit sectors. The authors declare no conflicts of interest. A portion of the salary of L. D. L. was covered by a core support grant, IAHPC Core Support, from the U.S. Cancer Pain Relief Committee and the grant Advancing palliative care through advocacy for policy changes from Open Society Foundations (grant number: OR2018-41903). Lukas Radbruch is chair of the board of directors of the IAHPC. Liliana de Lima is chief executive officer of the IAHPC. Katherine Pettus is employed as advocacy officer of the IAHPC. Marry Callaway, Julia Downing, Hibah Osman, Dingle Spence, Citra Venkateswaran, Roberto Wenk, and Roger Woodruff are members of the board of directors of IAHPC. Felicia Knaul has chaired the Lancet Commission on Global Access to Palliative Care and Pain Relief. Zipporah Ali is executive director of the Kenya Hospices and Palliative Care Association. Stephen Connor is executive director of the Worldwide Hospice and Palliative Care Alliance. Julia Downing is chief executive officer of the International Children's Hospice and Palliative Care Network. Philip Larkin is past president of the European Association for Palliative Care. Sebastien Moine is a member of the board of directors of the European Association for Palliative Care. M. R. Rajagopal is chairman of Pallium India. Tania Pastrana is president of the Asociaci?n Latinoamericana de Cuidados Paliativos. Ethical approval: The project did not involve any therapeutic intervention. Ethical aspects of the consensus project, for example, on data protection, were discussed extensively among the board of directors of IAHPC. The project plan was submitted to the Ethics Committee at the Fundacion Federaci?n M?dica de la Provincia de Buenos Aires in Argentina by one of the lead authors (R. W.) and was approved with no ethical issues raised.
Publisher Copyright:
© 2020 The Authors
PY - 2020/10
Y1 - 2020/10
N2 - Context: The International Association for Hospice and Palliative Care developed a consensus-based definition of palliative care (PC) that focuses on the relief of serious health-related suffering, a concept put forward by the Lancet Commission Global Access to Palliative Care and Pain Relief. Objective: The main objective of this article is to present the research behind the new definition. Methods: The three-phased consensus process involved health care workers from countries in all income levels. In Phase 1, 38 PC experts evaluated the components of the World Health Organization definition and suggested new/revised ones. In Phase 2, 412 International Association for Hospice and Palliative Care members in 88 countries expressed their level of agreement with the suggested components. In Phase 3, using results from Phase 2, the expert panel developed the definition. Results: The consensus-based definition is as follows: Palliative care is the active holistic care of individuals across all ages with serious health-related suffering due to severe illness and especially of those near the end of life. It aims to improve the quality of life of patients, their families and their caregivers. The definition includes a number of bullet points with additional details as well as recommendations for governments to reduce barriers to PC. Conclusion: Participants had significantly different perceptions and interpretations of PC. The greatest challenge faced by the core group was trying to find a middle ground between those who think that PC is the relief of all suffering and those who believe that PC describes the care of those with a very limited remaining life span.
AB - Context: The International Association for Hospice and Palliative Care developed a consensus-based definition of palliative care (PC) that focuses on the relief of serious health-related suffering, a concept put forward by the Lancet Commission Global Access to Palliative Care and Pain Relief. Objective: The main objective of this article is to present the research behind the new definition. Methods: The three-phased consensus process involved health care workers from countries in all income levels. In Phase 1, 38 PC experts evaluated the components of the World Health Organization definition and suggested new/revised ones. In Phase 2, 412 International Association for Hospice and Palliative Care members in 88 countries expressed their level of agreement with the suggested components. In Phase 3, using results from Phase 2, the expert panel developed the definition. Results: The consensus-based definition is as follows: Palliative care is the active holistic care of individuals across all ages with serious health-related suffering due to severe illness and especially of those near the end of life. It aims to improve the quality of life of patients, their families and their caregivers. The definition includes a number of bullet points with additional details as well as recommendations for governments to reduce barriers to PC. Conclusion: Participants had significantly different perceptions and interpretations of PC. The greatest challenge faced by the core group was trying to find a middle ground between those who think that PC is the relief of all suffering and those who believe that PC describes the care of those with a very limited remaining life span.
KW - Definition of palliative care
KW - Delphi method
KW - consensus
KW - low or middle income countries
KW - quality of life
KW - relief of suffering
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U2 - 10.1016/j.jpainsymman.2020.04.027
DO - 10.1016/j.jpainsymman.2020.04.027
M3 - Article
C2 - 32387576
AN - SCOPUS:85085916151
VL - 60
SP - 754
EP - 764
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
SN - 0885-3924
IS - 4
ER -