EAPC Atlas of Palliative Care in Europe 2019

Chapter 11. Integration of Oncology
and Palliative Care
EUROPEAN CONTEXT
B
TECHNICAL DATA
ON THE 2019 EAPC
SURVEY ON PALLIATIVE
CARE INTO ONCOLOGY
Population: 54 countries of the
Europe WHO region and Lichtenstein.
Complementary Survey
Areas explored: 5a) existence
of centres certified for the integration
of integrated Oncology
and PC, b) Clinical trials on
early integration of PC in Oncological
treatments and c) publications
on integration of PC in
Oncology.
Method: on-line search in public
databases: ESMO, Clinical
Trials.gov and Scopus.
Data collection: April 2019.
Project Management: ATLAN-
TES Research Group, Institute for
Culture and Society, University
of Navarra, Pamplona (Navarra),
Spain .
Scientific Advice: Carlos Centeno
(Spain).
Promotor: European Association
for Palliative Care (EAPC).
“palliative care is applicable early in the course of illness, in conjunction
with other therapies that are intended to prolong life,
such as chemotherapy or radiation therapy, and includes those
INVESTIGATIONS needed to better understand and manage distressing
clinical complications” (1).
The sentence from WHO’s current
definition of palliative care emphasizes
the importance of integrating
oncology and palliative care. Same
concept of the integration of PC throughout
the course of an illness is also contained in the
modern definition of IAHPC result of a broad
international consensus process (6).
Evidence from multiple randomized clinical
trials support the early integration of PC within
the oncological treatments: “true integration of
palliative and oncology care provides patients
with optimal oncology care” (VR & Temel). From
research and international consensus the integrated
care model has also become a topic in
cardiology, pneumology, and other specialties.
In this chapter we aim to review the situation
in Europe looking at three main indicators: a)
The existence of certified centres of integrated
Oncology and Palliative Care, b) the increasing
number of clinical trials addressing questions
regarding the early integration of Palliative Care
with anti-cancer treatments and c) the growing
number of scientific publications in the last few
years concerning our topic.
Rafael Martínez, Amaia Urritzola.
Our first search looked at the initiative of the
European Society of Medical Oncology (ESMO)
to improve the delivery of supportive and PC by
oncologists, oncology departments and cancer
centres. Through a rigorous process, since
2001, ESMO nominate centres that achieve
high standards of integration of both disciplines.
In 2018 there are more than 150 centres
from 25 countries.
Another test for the integration of PC with
Oncology could be the rising number of clinical
trials focusing on early PC in Oncology. Across
Europe more than 25 Clinical Trials started in
recent years. Eight of them are already concluded
and other are currently in recruitment
phase. France, Italy and Switzerland are leaders
in this research with over three trials running.
Regarding the publications of any kind, a quick
search (“oncology AND palliative care AND
integration”) performed by the Scopus scientific
database found 359 documents from European
countries published in the past 10 years.
To compare the situation, in the same period
the USA published almost 200. The country
ahead in this scientific interest is Germany, with
49 publications, followed by Italy, United Kingdom
and Israel with around 21 publications.
EAPC Atlas of Palliative Care in Europe
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