New global consensus-based definition of palliative care across all ages

Categories: Featured, Policy, and Research.

 

Last year a global consensus-based definition of palliative care encompassing both adults and children was created by the International Association of Hospice and Palliative Care (IAHPC). The definition has to date been endorsed by 129 organizations and 727 individuals from around the world and has been endorsed by the International Children’s Palliative Care Network (ICPCN).

Challenges of current definition

The current WHO definition for palliative care was developed in 2002 with the definition for children being even older, having been developed in 1998. Both these definitions pose similar challenges such as limiting palliative care to problems associated with life-threatening illnesses rather than being inclusive of those related to severe, chronic and complex conditions.

As an organization in formal relations with WHO, IAHPC undertook the project to design, develop and implement a new definition for palliative care based on consensus. This decision was motivated by a recommendation by the 2017 Lancet Commission on Global Access to Palliative Care and Pain Relief.  The report Alleviating the Access Abyss in Palliative Care and Pain Relief – An Imperative of Universal Health Coverage along with the framework to measure the global burden of serious health-related suffering (SHS) was based on 20 conditions or illnesses, many of which are acute (such as malnutrition, low birth weight, hemorrhagic fevers, injuries, poisoning, etc.) and may be transitory if adequately treated in time.

Broader concept of palliative care

This new approach by the Commission resulted in a broader concept of palliative care and the recommendation that the present WHO definition of palliative care be reviewed and revised to include health-system advances as well as low-income settings where medical professionals often have to care for patients with little or no access to necessary medicines, equipment or training.

Global consensus

In line with the recommendation of the Lancet Commission the IAHPC designed, developed and implemented a project to revise and adopt a new definition for palliative care based on global consensus. The initial statement of the definition refers to the provision of care ‘across all ages’ and reads: 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 project’s objective was to provide a definition focused on the relief of suffering that is timely and applicable to all patients regardless of the diagnosis, prognosis, geographic location, point of care and income level.

Method

During 2018, the method used to develop the definition saw the IAHPC develop a process based in three phases, including a large survey with over 400 IAHPC members from 88 countries.

The resulting definition consists of two sections and follows a similar structure to that of the WHO: a concise introductory statement and a list of components in bullet points. A third section was added after participants suggested adding a set of recommendations to governments.

Read the definition

You can read more on the project and those who participated in it on the IAHPC website and  can find the definition here.  You are also able to endorse this definition as an individual and/or an organisation via the same website.