Redefining Palliative Care—A New Consensus-Based Definition

Lukas Radbruch; Liliana De Lima; Felicia Knaul; Roberto Wenk; Zipporah Ali; Sushma Bhatnaghar; Charmaine Blanchard; Eduardo Bruera; Rosa Buitrago; Claudia Burla; Mary Callaway; Esther Cege Munyoro; Carlos Centeno; Jim Cleary; Stephen Connor; Odontuya Davaasuren; Julia Downing; Kathleen Foley; Cynthia Goh; Wendy Gomez-Garcia; Richard Harding; Quach T. Khan; Phillippe Larkin; Mhoira Leng; Emmanuel Luyirika; Joan Marston; Sebastien Moine; Hibah Osman; Katherine Pettus; Christina Puchalski; M. R. Rajagopal; Dingle Spence; Odette Spruijt; Chitra Venkateswaran; Bee Wee; Roger Woodruff; Jinsun Yong; Tania Pastrana

doi:10.1016/j.jpainsymman.2020.04.027

Redefining Palliative Care—A New Consensus-Based Definition

Lukas Radbruch, Liliana De Lima, Felicia Knaul, Roberto Wenk, Zipporah Ali, Sushma Bhatnaghar, Charmaine Blanchard, Eduardo Bruera, Rosa Buitrago, Claudia Burla, Mary Callaway, Esther Cege Munyoro, Carlos Centeno, Jim Cleary, Stephen Connor, Odontuya Davaasuren, Julia Downing, Kathleen Foley, Cynthia Goh, Wendy Gomez-GarciaRichard Harding, Quach T. Khan, Phillippe Larkin, Mhoira Leng, Emmanuel Luyirika, Joan Marston, Sebastien Moine, Hibah Osman, Katherine Pettus, Christina Puchalski, M. R. Rajagopal, Dingle Spence, Odette Spruijt, Chitra Venkateswaran, Bee Wee, Roger Woodruff, Jinsun Yong, Tania Pastrana

Palliative, Rehabilitation, and Integrative Medicine

Research output: Contribution to journal › Article › peer-review

410 Scopus citations

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.

Original language	English (US)
Pages (from-to)	754-764
Number of pages	11
Journal	Journal of pain and symptom management
Volume	60
Issue number	4
DOIs	https://doi.org/10.1016/j.jpainsymman.2020.04.027
State	Published - Oct 2020

Keywords

Definition of palliative care
Delphi method
consensus
low or middle income countries
quality of life
relief of suffering

ASJC Scopus subject areas

General Nursing
Clinical Neurology
Anesthesiology and Pain Medicine

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10.1016/j.jpainsymman.2020.04.027

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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, E. C., Centeno, C., Cleary, J., Connor, S., Davaasuren, O., Downing, J., Foley, K., Goh, C., ... Pastrana, T. (2020). Redefining Palliative Care—A New Consensus-Based Definition. Journal of pain and symptom management, 60(4), 754-764. https://doi.org/10.1016/j.jpainsymman.2020.04.027

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 2020, 'Redefining Palliative Care—A New Consensus-Based Definition', Journal of pain and symptom management, vol. 60, no. 4, pp. 754-764. https://doi.org/10.1016/j.jpainsymman.2020.04.027

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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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author = "Lukas Radbruch and {De Lima}, Liliana and Felicia Knaul and Roberto Wenk and Zipporah Ali and Sushma Bhatnaghar and Charmaine Blanchard and Eduardo Bruera and Rosa Buitrago and Claudia Burla and Mary Callaway and Munyoro, {Esther Cege} and Carlos Centeno and Jim Cleary and Stephen Connor and Odontuya Davaasuren and Julia Downing and Kathleen Foley and Cynthia Goh and Wendy Gomez-Garcia and Richard Harding and Khan, {Quach T.} and Phillippe Larkin and Mhoira Leng and Emmanuel Luyirika and Joan Marston and Sebastien Moine and Hibah Osman and Katherine Pettus and Christina Puchalski and Rajagopal, {M. R.} and Dingle Spence and Odette Spruijt and Chitra Venkateswaran and Bee Wee and Roger Woodruff and Jinsun Yong and Tania Pastrana",

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AU - Radbruch, Lukas

AU - De Lima, Liliana

AU - Knaul, Felicia

AU - Wenk, Roberto

AU - Ali, Zipporah

AU - Bhatnaghar, Sushma

AU - Blanchard, Charmaine

AU - Bruera, Eduardo

AU - Buitrago, Rosa

AU - Burla, Claudia

AU - Callaway, Mary

AU - Munyoro, Esther Cege

AU - Centeno, Carlos

AU - Cleary, Jim

AU - Connor, Stephen

AU - Davaasuren, Odontuya

AU - Downing, Julia

AU - Foley, Kathleen

AU - Goh, Cynthia

AU - Gomez-Garcia, Wendy

AU - Harding, Richard

AU - Khan, Quach T.

AU - Larkin, Phillippe

AU - Leng, Mhoira

AU - Luyirika, Emmanuel

AU - Marston, Joan

AU - Moine, Sebastien

AU - Osman, Hibah

AU - Pettus, Katherine

AU - Puchalski, Christina

AU - Rajagopal, M. R.

AU - Spence, Dingle

AU - Spruijt, Odette

AU - Venkateswaran, Chitra

AU - Wee, Bee

AU - Woodruff, Roger

AU - Yong, Jinsun

AU - Pastrana, Tania

PY - 2020/10

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N2 - 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.

AB - 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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KW - consensus

KW - low or middle income countries

KW - quality of life

KW - relief of suffering

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Redefining Palliative Care—A New Consensus-Based Definition

Abstract

Keywords

ASJC Scopus subject areas

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