Palliative care is a specialized, interdisciplinary medical care that aims to improve the quality of life of people with serious illnesses, their families, and caregivers.1-4 The National Coalition for Hospice and Palliative Care (NCHPC)’s 2018 National Consensus Project highlights eight key domains of palliative care that draw attention to the physical, psychological, social, religious, cultural, ethical, and legal aspects of care, as well as the coordination of care and the care of patients nearing end of life.1 Taking into account the wide range of care, the NCHPC guidelines emphasize an interdisciplinary and team-based approach to palliative care.1 A team of specially trained doctors, nurses, and other specialists deliver palliative care to provide an added layer of support to maximize patient and family quality of life by coordinating care with a patient’s other doctors and healthcare professionals.3 According to a 2018 systematic review on multicomponent palliative care interventions for patients with advanced chronic diseases, most of the care is provided by nurses (88%), followed by physicians (67%), social workers (52%), chaplains (30%), physical and occupational therapists (27%), and psychologists (22%).5
Palliative care can also be delivered by healthcare professionals who care for the seriously-ill population, but are not palliative care specialists (e.g., primary care physicians, disease-oriented specialists, nurses, social workers, chaplains, and pharmacists).1 Regardless of diagnosis or prognosis, general palliative care should be considered as a vital and routine part of clinical practice that promotes physical and psychosocial health. All health professionals serving seriously ill patients and their families and caregivers should consider and acquire palliative care knowledge and skills as core competencies. Multiple studies have demonstrated that palliative care can enhance the quality of life of both patients with serious illnesses and their family members.6 A 2016 systematic review and meta-analysis found that palliative care interventions were consistently associated with improved quality of life, symptom burden, advance care planning, patient and caregiver satisfaction, and lower health care utilization in 43 randomized controlled trials on 12,731 patients and 2,469 caregivers.7 In addition, a 2018 systematic review of systematic reviews (n=139) conducted to support the NCHPC’s National Consensus Project guidelines consistently found that interdisciplinary care teams (13 reviews) improved quality of life of patients with serious illness.8
- National Consensus Project for Quality Palliative Care. Clinical practice guidelines for quality palliative care, 4th edition. Richmond, VA: National Coalition for Hospice and Palliative Care; 2018. https://www.nationalcoalitionhpc.org/ncp.
- IOM (Institute of Medicine). 2014. Dying in America: Improving quality and honoring individual preferences near the end of life. Washington, DC: The National Academies Press.
- Elizabeth, H, McInturff, B. 2011 Public opinion research on palliative care. Center to Advance Palliative Care (CAPC) with support from the American Cancer Society (ACS) and the American Cancer Society Cancer Action Network (ACS CAN). 2011. https://media.capc.org/filer_public/18/ab/18ab708c-f835-4380-921d-fbf729702e36/2011-public-opinion-research-on-palliative-care.pdf. Accessed Dec 26, 2018. .
- World Health Organization. 2018. WHO definition of palliative care. https://www.who.int/cancer/palliative/definition/en/. Accessed Dec 26, 2018.
- Phongtankuel V, Meador L, Adelman RD, et al. Multicomponent palliative care interventions in advanced chronic diseases: a systematic review. Am J Hosp Palliat Care. 2018;35(1):173-183.
- Kozlov E, McDarby M, Reid MC, Carpenter BD. Knowledge of palliative care among community-dwelling adults. Am J Hosp Palliat Care. 2018;35(4):647-651.
- Kavalieratos D, Corbelli J, Zhang D, et al. Association between palliative care and patient and caregiver outcomes: a systematic review and meta-analysis. JAMA. 2016;316(20):2104-2114.
- Ahluwalia SC, Chen C, Raaen L, et al. A systematic review in support of the national consensus project clinical practice guidelines for quality palliative care, fourth edition. J Pain Symptom Manage. 2018;56(6):831-870.