What is palliative care?
According to the World Health Organization, palliative care can be defined as:
"An approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual".1
One goal of palliative care is for the patients and families to accept dying as a normal process. It seeks to provide relief from pain and uncomfortable symptoms while integrating psychological and spiritual features of patient care. Palliative care strives to offer a support system to help patients live their remaining time as actively as they can and to help families bereave and deal with the illness of a loved one.2
Since pain is the most visible sign of distress among patients receiving palliative care, affecting about 70% of cancer patients and 65% of patients dying from non-malignant diseases, opioids are a very common treatment option 3. These medicines form part of well-established treatment plans for managing pain as well as several other symptoms that patients encounter. Often, opioids are chosen during palliative care in spite of the side effects such as drowsiness, nausea, vomiting, and constipation.
Some type of palliative care is given to 45,000 new patients each year in England, Wales, and Northern Ireland. About 90% of these patients have cancer, while the remaining patients have heart disease, stroke, motor neuron disease, or multiple sclerosis. The providers of the palliative care include in-patient care, hospital support services, community care, day care and outpatient care.4
1. Sepulveda C, Marlin A, Yoshida T, Ullrich A. Palliative Care: The World Health Organization's Global Perspective. J Pain Sym Man. 2002; 24: 91-6
2. The National Council for Palliative Care. Palliative Care Explained (Accessed 30 April 2008) Available at http://www.ncpc.org.uk/palliative_care.html
3. Colvin L, Forbes K, Fallon M; Difficult pain. BMJ. 2006; 332 (7549):1081-3.
4. The National Council for Palliative Care, National Survey of Patient Activity Data for Specialist Palliative Care Service, MDS Full Report for the year 2005 - 2006