Publications
Partners
In a perspective published in New England Journal of Medicine, Quill, who serves as president of the American Academy of Hospice and Palliative Medicine (AAHPM), suggests that arming generalists and other specialists with primary palliative care skills is a practical, cost-effective and sustainable way to expand the delivery of palliative care.
Born out of
a hospice tradition, palliative care offers relief of pain and symptoms and
assistance with medical decision-making to anyone with a serious illness,
regardless of prognosis.
Lessen pain and provide family support
The goal is to alleviate patient suffering through high-quality pain and symptom management and to provide added support for patients and their families – all while patients are receiving effective medical treatment of their underlying disease.
Quill says that with appropriate education and training, many fundamental aspects of palliative care can be provided by those already caring for a patient.
This could avoid adding another team of caregivers to a patient's care or setting the expectation that certain palliative care tasks – such as basic symptom management and psychosocial support – are only the role of a palliative care provider.
"In a coordinated
palliative care model, the primary care physician or treating specialist could
manage many palliative care problems, initiating a palliative care consultation
for more complex situations," Quill said.
Increased access to care
"When this occurs, the patient may eventually return to the referring specialist or the primary care physician for ongoing palliative care management when that is deemed desirable by everyone involved. This model allows increased access to specialty palliative care consultation and reinforces delivery of primary palliative care by everyone caring for seriously ill patients."
"There has been increasing emphasis on including palliative care as a fundamental part of the care of people with serious illness because it leads to better quality of life, less depression, less health care waste, and maybe even longer survival," said Amy P Abernethy, MD, of Duke University School of Medicine, who co-authored the perspective.
"Better symptom control, defining and aligning goals of care, and attention to the needs of the family are just some of the fundamental principles of palliative care to be included in the generalist and specialist palliative care toolbox."
