title: Understanding the challenges to improve transition to palliative care: An issue for the primary malignant brain tumour population.
abstract: Reports highlight the growing unmet need for palliative care as it applies to all cancers, yet the system and health care professionals (HCP) appear slow to respond. The following discussion paper highlights the current state of palliative care within the context of the primary malignant brain tumour (PMBT) population and argues for a shift in the current health care system's approach, which continues to place greater emphasis on cure over care.
  
  
  METHODS
  An exploration of extant literature over the past 10 years.
  
  
  RESULTS
  The current literature demonstrates that timely referrals to palliative care consult teams and access to community-based resources have been associated with fewer hospitalizations and visits to emergency departments and a decrease in the initiation of invasive, aggressive treatment at end of life. Timely referral to palliative care has also been shown to reduce distress, enhance quality of life and, in some cases, increase life expectancy.
  
  
  CONCLUSIONS
  Earlier referral to palliative care has yet to become a reality for many patients diagnosed with life-limiting illnesses and, in particular, those with a PMBT. More research is needed to uncover and challenge the barriers to early transition including communication issues among professionals, patients and families around palliative care.
authors.forename: Brenda
authors.initials: B
authors.lastname: Sabo
authors.forename: Grace
authors.initials: G
authors.lastname: Johnston
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000451:nursing*; D005260:Female; D064946:Hospice and Palliative Care Nursing / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000458:organization & administration*; D010360:Patient Transfer; D012017:Referral and Consultation / Q000458:organization & administration*; D013727:Terminal Care / Q000458:organization & administration*; D000069341:Transitional Care / Q000458:organization & administration*