Mixed access to home palliative care – study

Access to palliative care at home for terminally ill patients depends heavily on the diagnosis, researchers say today.

The Leeds University study finds that palliative care is the key to good pain relief at home for people with advanced progressive diseases – but access is unequally distributed.

Some 66% of patients with cancer received palliative care at home compared with 10% of those with other diseases, the researchers report in the journal BMC Medicine.

The findings come from an analysis of five years of the annual National Bereavement Survey.

Researchers found that those receiving palliative care were 2.7 times more likely to have received effective pain relief than those not getting this care.

It also found that patients receiving hospice care experienced the best pain relief – reported as good by 87% of families.

Researcher Dr Yousuf Elmokhallalati said: “This research shows that palliative care is associated with significant benefits to people with every kind of progressive disease, but this is not reflected in the spread of people that are being offered palliative care.

“We need to ensure that all people, whether they have cancer, heart or lung diseases, or any other life-limiting condition, are being offered appropriate support towards the end of their lives.”

Fellow researcher Professor Mike Bennett, professor of palliative medicine, said: "It’s already been established that the home is the place where pain is least well controlled, so our findings clearly illustrate the importance of access to end of life care.

“These results, combined with our previous research, suggest that pain relief and access to palliative care is particularly poor for older patients, those with non-cancer diseases and those who live in the North of England. These inequalities must be challenged.”

Specialist palliative care support is associated with improved pain relief at home during the last 3 months of life in patients with advanced disease: analysis of 5-year data from the national survey of bereaved people (VOICES). BMC Medicine 22 March 2019

https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-019-1287-8

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