EAPC Atlas of Palliative Care in Europe 2019

PRESENTATION
Note from the authors
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In 2017, four years after the last edition
of the EAPC Atlas of Palliative
Care in Europe, we decided that it
was time to conduct a new assessment
of palliative care development within
the World Health Organisation (WHO)
European Region. The experience we have
gathered over the recent years mapping
palliative care progress in Latin America,
Africa and the Eastern Mediterranean
countries led us to wonder about the best
way of evaluating not only development but
also the integration of PC into health systems.
We set ourselves on a quest to scientifically
approaching this issue.
For the present publication, we improved
our methodology aimed at gathering the
most comprehensive and up-to-date information
on the region. The selection of the
indicators to be used in the Atlas was a crucial
point. We started by conducting a systematic
review to identify all national-level
indicators used in the last ten years in
cross-national studies around the world.
These indicators were clustered following
the four WHO dimensions: policies, use of
medicines, education and service provision.
We then invited a committee of 24
international experts on palliative care
development to take part in a two-round
Delphi process to assess these indicators
and achieve consensus on the selection
of the best ones. Twenty–five indicators
resulting from this process were used in
the making of this Atlas.
Simultaneously, we studied the integration
of palliative care in the region and chose
paediatric palliative care, long-term care
facilities, primary care, volunteering, cardiology
and oncology as fields to assess.
We contacted experts in these fields and
invited them to enrol in a design and selection
process of specific indicators for each
one. Thirty-three indicators were used on
the making of the chapters assessing palliative
integration. Additionally, we created
networks of key informants to respond
them. Besides, a dedicated study on palliative
care education at the undergraduate
level, and on integration of palliative care
and oncology were conducted.
This edition present data gathered on the
development of palliative care within the
region. As a result, it provides a regional
overview of the current progress of palliative
care in the section Development and
integration of Palliative Care across Europe
(chapters 1 to 11). Separately, national
profiles of each country are presented in
the section Development of Palliative Care
at the country-level.
This publication presents the first regional
study of its kind using consensus-based
indicators for the assessment of specialised
palliative care development and indicators
designed specifically to explore the
state of integration of palliative care within
Primary Care, Paediatric palliative care,
Long-Term Care Facilities, Cardiology and
Oncology within the region. All of it in line
with WHO and providing a handful of helpful
new baseline indicators. It provides
information on 94% (51/54) of countries
of the region and enables cross-national
comparison on the progress of PC
among countries. Information was provided
by key informants in each country, which
consisted of leaders of national palliative
care associations, members of the Ministry
of Health, or experts within each country
defined as either the leader of an important
hospice or palliative care service. Peer
review, literature review and ATLANTES
Research Programme’s databases were
used to verify information given by experts.
Therefore, the EAPC Atlas is presenting with
the best estimates available.
Following this EAPC Atlas, we will continue
to work on secondary analyses of the
data we have collected for publication in a
series of scientific papers and reports. We
will focus on disseminating this information
to key experts in European countries
so that it may be used for advocacy efforts
in working with governments and Ministries
of Health.
This ambitious project was made possible
thanks to the collaboration of over 450 palliative
care professionals across Europe,
who have contributed in various meaningful
ways. We truly thank all of those who
volunteered their time for the project. We
thank the key informants, country and
sub-specialty experts, and international
committee members for all of their assistance
in making this EAPC Atlas of Palliative
Care a reality as well as their tireless work in
building up palliative care in their respective
countries.
EAPC Atlas of Palliative Care in Europe
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