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Radbruch L, De Lima L, Knaul F, Wenk R, Ali Z, Bhatnaghar S, Blanchard C, Bruera E, Buitrago R, Burla C, Callaway M, Munyoro EC, Centeno C, Cleary J, Connor S, Davaasuren O, Downing J, Foley K, Goh C, Gomez-Garcia W, Harding R, Khan QT, Larkin P, Leng M, Luyirika E, Marston J, Moine S, Osman H, Pettus K, Puchalski C, Rajagopal MR, Spence D, Spruijt O, Venkateswaran C, Wee B, Woodruff R, Yong J, Pastrana T. Redefining Palliative Care-A New Consensus-Based Definition. J Pain Symptom Manage 2020; 60:754-764. [PMID: 32387576 PMCID: PMC8096724 DOI: 10.1016/j.jpainsymman.2020.04.027] [Citation(s) in RCA: 334] [Impact Index Per Article: 83.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/14/2020] [Accepted: 04/24/2020] [Indexed: 01/03/2023]
Abstract
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.
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Affiliation(s)
- Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany.
| | - Liliana De Lima
- International Association for Hospice and Palliative Care, Houston, Texas, USA
| | - Felicia Knaul
- University of Miami Institute for Advanced Study of the Americas, Coral Gables, Florida, USA
| | | | - Zipporah Ali
- Kenian Hospice and Palliative Care Association, Nairobi, Kenya
| | - Sushma Bhatnaghar
- Department of Onco-Anaesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Charmaine Blanchard
- Wits Centre for Palliative Care, University of the Witwatersrand Johannesburg, Johannesburg, South Africa
| | - Eduardo Bruera
- Department of Palliative Rehabilitation and Integrative Medicine, MD Anderson Cancer Center Houston, Houston, Texas, USA
| | - Rosa Buitrago
- School of Pharmacy, University of Panama, Panama City, Panama
| | | | | | | | - Carlos Centeno
- Department of Palliative Medicine, Clinica Universidad de Navarra, Navarra, Spain
| | - Jim Cleary
- Department of Medicine, IU Simon Cancer Center, IU School of Medicine, Indianapolis, Indiana, USA
| | - Stephen Connor
- Worldwide Hospice Palliative Care Alliance, London, United Kingdom
| | - Odontuya Davaasuren
- General Practice and Basic Skills Department, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Julia Downing
- International Children's Palliative Care Network, Cape town, South Africa
| | | | - Cynthia Goh
- Division of Palliative Medicine at the National Cancer Centre Singapore, Singapore
| | - Wendy Gomez-Garcia
- Clínica de Linfomas and LMA Cuidados Paliativos and Terapia Metronómica, Hospital Infantil Dr. Robert Reid Cabral, Santo Domingo, Dominican Republic
| | - Richard Harding
- Centre for Global Health Palliative Care, King's College London, London, United Kingdom
| | - Quach T Khan
- Palliative Care Department, Ho Chi Minh City Oncology Hospital, Ho Chi Minh City, Vietnam
| | - Phillippe Larkin
- Institut universitaire de formation et de recherche en soins, Universite de Lausanne, Lausanne, Switzerland
| | - Mhoira Leng
- Department of Palliative Care, Makerere University, Kampala, Uganda
| | | | - Joan Marston
- International Children's Palliative Care Network, Cape town, South Africa
| | - Sebastien Moine
- Health Education and Practices Laboratory, University Parisse, Villetaneuse, France
| | - Hibah Osman
- Palliative and Supportive Care Program at the American University of Beirut Medical Center, Beirut, Lebanon
| | - Katherine Pettus
- International Association for Hospice and Palliative Care, Houston, Texas, USA
| | - Christina Puchalski
- George Washington University's Institute for Spirituality and Health, Washington, District of Columbia, USA
| | - M R Rajagopal
- Trivandrum Institute of Palliative Sciences, Trivandrum, Kerala, India
| | | | - Odette Spruijt
- Australasian Palliative Link International, Melbourne, Australia
| | | | - Bee Wee
- Sir Michael Sobell House, Oxford University Hospital, Oxford, United Kingdom
| | | | - Jinsun Yong
- College of Nursing Catholic, University of Korea, Seoul, South Korea
| | - Tania Pastrana
- Department of Palliative Medicine, University Hospital Aachen, Aachen, Germany
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