Palliative care and primary health care: a challenge

Marinela Olăroiu, MD, PhD, Editor-in-Chief of PALIAŢIA

For many years, the World Health Organization (WHO) and other international organizations call for universal access of palliative care. However, palliative care still reaches a minority of people who would benefit from palliative care. Besides, palliative care is often introduced to late because it is thought to be beneficial only for patients in the terminal phase of a disease (actually mostly cancer). The European Association for Palliative Care (EAPC) argues that to realise universal coverage palliative care should be integrated in primary health care. This would also stimulate the use of palliative care support in time. This is still a problem as recent data from the USA show (see NEWS in this issue of PALIAŢIA).

With well-formulated arguments, EAPC has started a workgroup to promote the integration of palliative care in primary health care. Explicitly the workgroup calls for people, who want to contribute from Eastern European countries (for more details and the work plan see News in this issue of PALIATIA or go here.

As you may read in this issue of PALIATIA, the ‘old idea’ that palliative care is only of importance in the terminal phase of a disease and should be delivered in ‘special places’ outside the regular health care system, is not shared any longer in Romania. Multidisciplinary palliative care teams are needed in hospitals. Such teams may also support primary health care professionals to deliver palliative care at home, if patients and family prefer.

At the same time, it could be a golden opportunity for the primary health care to become again the keystone of the national health care system. However, it would ask for various changes and innovations in the way the primary health care system is functioning and financed today. Who will use this opportunity to strengthen the quality and organization of primary health care and palliative care? As the EAPC calls: ‘If you are passionate about improving palliative care in the community in your country’.

About how difficult is to deliver palliative care at home, please access a recent article publish in Romanian Journal of Family Medicine. ’’I present a real case about the management by a general practitioner to show difficulties in assessment and care planning. An important objective in primary medical care is early identification of patients, who need palliative care, to prepare the appropriate plan and instruments’’. Full text here.