Key result
The level of integrated palliative care content in European guidelines was similar between cancer (median score 5) and CHF/COPD (median score 7), suggesting guideline content alone does not explain the inequity in palliative care access.
Why the study?
Does the content of guidelines/pathways for CHF/COPD differ in the level of integrated palliative care compared to cancer guidelines in Europe?
Does the content of guidelines/pathways for CHF/COPD differ in the level of integrated palliative care compared to cancer guidelines in Europe?
The inequity in access to palliative care between cancer and CHF/COPD patients in Europe cannot be solely attributed to differences in the content of published guidelines, as their levels of palliative care integration are statistically similar.
Answers are grounded in this paper and cite their sources.
Guideline content does not explain palliative care inequity in CHF/COPD; leaves open implementation and systemic barriers for investigation.
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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Siouta et al. (2017) studied Cancer and Chronic Heart Failure (CHF) / Chronic Obstructive Pulmonary Disease (COPD) (n=93). Cancer guidelines/pathways vs. CHF/COPD guidelines/pathways was evaluated on Median Integrated Palliative Care (IPC) score (0-11 scale) (p=0.19). The level of integrated palliative care content in European guidelines was similar between cancer (median score 5) and CHF/COPD (median score 7), suggesting guideline content alone does not explain the inequity in palliative care access.
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