Palliative care in primary care: European Forum for Primary Care position paper

Abstract

Aim:The aim of this position paper is to assist primary health care (PHC) providers, policymakers, and researchers by discussing the current context in which palliative health care functions within PHC in Europe. The position paper gives examples for improvements to palliative care models from studies and international discussions at European Forum for Primary Care (EFPC) workshops and conferences.Background:Palliative care is a holistic approach that improves the quality of life of patients and their families facing problems associated with terminal illness, through the prevention and relief of suffering by means of early identification and diligent assessment and treatment of pain and other problems, whether physical, psychosocial, or spiritual. Unfortunately, some Europeans, unless they have cancer, still do not have access to generalist or specialist palliative care.Methods:A draft of this position paper was distributed electronically through the EFPC network in 2015, 2016, and 2017. Active collaboration with the representatives of the International Primary Palliative Care Network was established from the very beginning and more recently with the EAPC Primary Care Reference Group. Barriers, opportunities, and examples of good and bad practices were discussed at workshops focusing on palliative care at the international conferences of Southeastern European countries in Ljubljana (2015) and Budva (2017), at regular conferences in Amsterdam (2015) and Riga (2016), at the WONCA Europe conferences in Istanbul (2015), Copenhagen (2016), and Prague (2017), and at the EAPC conference in Madrid (2017).Findings:There is great diversity in the extent and type of palliative care provided in primary care by European countries. Primary care teams (PCTs) are well placed to encourage timely palliative care. We collected examples from different countries. We found numerous barriers influencing PCTs in preparing care plans with patients. We identified many facilitators to improve the organization of palliative care.

General Practitioners’ Perspectives on General and Specialized Palliative Home Care in North Rhine, Germany: An Explorative Focus Group Study

“…These findings are comparable to previous studies and thus also transferable to North Rhine. [41][42][43] The focus group stressed, for example, the nontransparent organization of PC 30 and that the need to provide home visits is difficult for GPs to implement. 29,41…”

Rethinking palliative care in a public health context: addressing the needs of persons with non-communicable chronic diseases

“…Additionally, early training on PC seems to have positive effects on future professionals' competences (Parikh et al, 2017;El-Sourady et al, 2019). These examples highlight the core role of all-level education and training in PC transformation (Rotar Pavlič et al, 2019).…”

Predictors of At-Home Death for Cancer Patients in Rural Clinics in Japan

“…Using recent technology to overcome the remoteness (i.e., e-learning based on information and communication technology) of rural clinics can be an important strategy for facilitating at-home death [ 17 ]. In addition, the usefulness of interdisciplinary work on palliative care has been well established [ 18 , 19 , 20 ]. Even while there are few human resources, the formation of such a collaborative team would be necessary for rural clinics.…”