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. 2022 Apr;36(4):680-697.
doi: 10.1177/02692163221074547. Epub 2022 Feb 3.

Revised recommendations on standards and norms for palliative care in Europe from the European Association for Palliative Care (EAPC): A Delphi study

Sheila Payne  1 , Andrew Harding  1 , Tom Williams  1 , Julie Ling  2 , Christoph Ostgathe  3
Affiliations

Revised recommendations on standards and norms for palliative care in Europe from the European Association for Palliative Care (EAPC): A Delphi study

Sheila Payne et al. Palliat Med. 2022 Apr.

Abstract

Background: In 2009, the EAPC published recommendations on standards and norms for palliative care in Europe, and a decade later, wished to update them to reflect contemporary practice.

Aim: To elicit consensus on standards and norms for palliative care in Europe, taking account of developments since 2009.

Design: A Delphi technique used three sequential online survey rounds, and a final expert consultation (EAPC Board). The original 2009 questionnaire with 134 statements was updated with 13 new concepts and practices following a scoping of the literature between 2009 and 2020 (total: 147 statements).

Setting/participants: One contact of Boards of 52 national European organisations affiliated to the EAPC were invited to participate, with subsequent rounds sent to respondees. The EAPC Board (n = 13) approved final recommendations.

Results: In Round 1: 30 organisations (14 organisations × two people, 16 organisations × one person, total n = 44) in 27 countries responded (response rate 58% organisations, 82% countries), Round 2 (n = 40), Round 3 (n = 38). 119 statements reached consensus in Round 1, 9 in Round 2, 7 in Round 3. In total 135/145 statements in five domains (terminology, philosophy, levels, delivery, services) reached consensus (defined as >75% agreement), (122) were original EAPC recommendations with 13 new recommendations included emerging specialisms: neonatal, geriatric and dementia care, and better care practices. Seven statements failed to reach consensus and four were removed as irrelevant or repetition.

Conclusions: Most recommendations on standards and norms for palliative care in Europe remain unchanged since 2009. Evolving concepts in palliative care can be used to support advocacy.

Keywords: Delivery of Health Care; Delphi technique; Palliative care; end-of-life care; surveys and questionnaires.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow chart of three round Delphi process. *Two items omitted after R1 Supportive care should not be used as a synonym of palliative care. Population served, Adequate provision of palliative care for noncancer patients requires additional resources. If non-cancer patients were to have equal access to palliative care compared to cancer patients, the percentages of patients requiring palliative care are estimated at 40% (non-cancer patients) and 60% (cancer patients) respectively. **Two items omitted after R2 Non-specialist Palliative Care, Hospital at home.
See this image and copyright information in PMC

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