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.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088685 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-684X (Electronic) Linking ISSN: 1472684X NLM ISO Abbreviation: BMC Palliat Care Subsets: MEDLINE

Original Publication: London : BioMed Central, [2002-

Delivery of Health Care, Integrated/*trends ; Guidelines as Topic/*standards ; Healthcare Disparities/*standards ; Palliative Care/*statistics & numerical data; Aged ; Europe ; Female ; Heart Failure/therapy ; Humans ; Male ; Neoplasms/therapy ; Pulmonary Disease, Chronic Obstructive/therapy

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.

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305555 FP7/HEALTH

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

Date Created: 20171129 Date Completed: 20180927 Latest Revision: 20240327

20240327

PMC5704525

10.1186/s12904-017-0243-7

29179703