Promoting palliative care in the community: production of the primary palliative care toolkit by the European Association of Palliative Care Taskforce in primary palliative care.
BACKGROUND
A multidisciplinary European Association of Palliative Care Taskforce was established to scope the extent of and learn what facilitates and hinders the development of palliative care in the community across Europe.


OBJECTIVE
To document the barriers and facilitators for palliative care in the community and to produce a resource toolkit that palliative care specialists, primary care health professionals or policymakers, service developers, educationalists and national groups more generally could use to facilitate the development of palliative care in their own country.


METHODS
(1) A survey instrument was sent to general practitioners with knowledge of palliative care services in the community in a diverse sample of European countries. We also conducted an international systematic review of tools used to identify people for palliative care in the community. (2) A draft toolkit was then constructed suggesting how individual countries might best address these issues, and an online survey was then set up for general practitioners and specialists to make comments. Iterations of the toolkit were then presented at international palliative care and primary care conferences.


RESULTS
Being unable to identify appropriate patients for palliative care in the community was a major barrier internationally. The systematic review identified tools that might be used to help address this. Various facilitators such as national strategies were identified. A primary palliative care toolkit has been produced and refined, together with associated guidance.


CONCLUSIONS
Many barriers and facilitators were identified. The primary palliative care toolkit can help community-based palliative care services to be established nationally.
Primary Palliative Care Research Group, Medical School, University of Edinburgh, Edinburgh, UK Scott.Murray@ed.ac.uk.
Scott A
SA
Murray
University of Edinburgh, Edinburgh, UK.
Adam
A
Firth
Hannover Medical School, Hannover, Germany.
Nils
N
Schneider
University of Antwerp, Antwerp, Belgium.
Bart
B
Van den Eynden
WHO Collaborating Centre for Public Health Palliative Care Programmes, Catalan Institute of Oncology, Barcelona, Spain.
Xavier
X
Gomez-Batiste
Research Unit for General Practice, Aarhus University, Aarhus, Denmark.
Trine
T
Brogaard
University of Lisbon, Santa Maria Hospital, Lisbon, Portugal.
Tiago
T
Villanueva
Department of Primary Health, Floriana, Malta.
Jurgen
J
Abela
Center for Palliative Care, Kantonsspital St. Gallen Institute, St. Gallen, Switzerland.
Steffen
S
Eychmuller
University of Queensland, St Lucia, QLD, Australia.
Geoffrey
G
Mitchell
Makerere University, Kampala, Uganda Development of Palliative Care Services, Belgrade, Republic of Serbia.
Julia
J
Downing
St Joseph's Hospice, London, UK.
Libby
L
Sallnow
General Practice Hopveld, Den Dungen, The Netherlands.
Erik
E
van Rijswijk
University of Cape Town, Cape Town, South Africa.
Alan
A
Barnard
The Irish Hospice Foundation, Dublin, Ireland.
Marie
M
Lynch
Centre Hospitalier Luxembourg (CHL), Rue Nicolas Ernest Barblé, Luxembourg.
Frederic
F
Fogen
Laboratoire de pédagogie de la santé, Université Paris 13 Département de recherche en éthique, Université Paris-Sud, Orsay, France.
Sébastien
S
Moine
D000349:Africa / Q000453:epidemiology; D003153:Community Health Services / Q000458:organization & administration*; D003431:Cross-Cultural Comparison; D004493:Education; D005060:Europe / Q000453:epidemiology; D017144:Focus Groups; D006801:Humans; D009520:New Zealand / Q000453:epidemiology; D010166:Palliative Care / Q000458:organization & administration* / Q000592:standards* / Q000639:trends; D011320:Primary Health Care / Q000458:organization & administration*; D036301:Qualitative Research; D058996:Quality Improvement; D013020:South America / Q000453:epidemiology
Palliative care; community health services; policy; primary health care; primary palliative care; qualitative research