Research in palliative care and implementation into practice

Prof Wim JA van den Heuvel, Chairman of PALIAŢIA

The need to stimulate palliative care in practice and in research is widely recognized. Of course by the experts in the field, but also by various international organisations (World Health Organisation, United Nations, the Council of Europe, the European Union). Various EU countries have special research programs for palliative care; the EU stimulates international cooperation in palliative care research. The European Association for Palliative Care (EAPC) organizes – already for years – special programs for researchers and awards the best research articles. Already ten years ago the EAPC published a White Paper on standards and norms for hospice and palliative care in Europe.

But more is needed. Palliative care is still not an integrated part of health care services. Policy makers are often not well informed about the need and importance of palliative care. Therefore, the World Health Organization developed last year an online course to train palliative care workers on the development of national policies. Will it be helpful? Let’s hope so! But till now, such actions has not brought evident results.

Some journals on palliative care and medicine present a list of the best articles, which are published in their journals. In various countries, worldwide, national organisations on palliative and hospice care present yearly awards for persons, who did outstanding work to stimulate palliative care. Will it be helpful? Let’s hope so! But till now, such actions has not brought evident results.

Besides the major political and policy problems to realize that palliative care is an integrated part of health care, there is another nasty one. How to ensure that new research outcomes, which may and stimulate palliative care and improve the quality of care, find their way into every-day practice. Implementation is sometimes seen as an automatic process, but it is not. There are many obstacles to introduce evidence-based innovations and improvements into practice. One of the obstacles is that people (so, also health care professionals) like to work as they are used to. Another one is that one believes – or want to believe – that research outcomes, which are based on studies in other countries with other health care systems and regulations, will not ‘work’ here. And another one is, that regulations (guidelines, finances etc.) has to be adjusted. And another one is ……..

Implementation of new treatments, based on evidence-based research, is not easy, but the efforts are worth it: it improves the quality of care and the quality of life of patients and health care workers. Which policy maker would not like to realize these?