Key Points
➤ The purpose of this pocket guide is to provide expert guidance to clinicians
and policymakers on implementing aspects of palliative care — for
example, the personnel, training, workforce, model and timing of palliative
care — in resource-constrained settings.
➤ It is intended to complement the Integration of Palliative Care Into
Standard Oncology Care: American Society of Clinical Oncology (ASCO)
Clinical Practice Guideline Update of 2016. (http://ascopubs.org/
doi/10.1200/JCO.2016.70.1474)
➤ All recommendations underwent Formal Consensus.
Recommendations
Palliative Care Models
Recommendation 1.0 General
➤ There should be a coordinated system where the palliative care needs of
patients and families are identified and met at all levels, in collaboration
with the team providing oncology care. The health care system should have
trained personnel who are licensed to prescribe, deliver, and dispense
opioids at all levels. Distance communication should be instituted at the
national or regional level through oncology centers (or other tertiary care
centers) to support those providing oncology care to patients in lower
resource areas. (FC)
Recommendation 1.1 Basic (Primary Health Care)
➤ Palliative care needs should be addressed in the community or at the
primary health care center. These needs may be addressed by primary
health care providers, nurses, community health workers, volunteers, and/
or clinical officers. (Moderate Recommendation; EB/FC-I)
Recommendation 1.2 Limited (District)
➤ In addition to provision of palliative care in the community and at
primary health care centers, outpatient palliative care services should be
established. When a counselor is not available, psychosocial and spiritual
needs may be addressed by team members trained in basic palliative care.
(Moderate Recommendation; FC-I)
