Palliative Care in the Global Setting

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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. ( 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)

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