Palliative care for older people - World Health Organization ...

16© Joan TenoThe need for research on palliative care for older people“Palliative medicine is a rapidly evolving field,which is quickly moving to redress its historicalpaucity of high-quality research evidence.”Source: Currow et al. (1).This publication includes examples of innovativeapproaches to improve palliative care for olderpeople. Since many of these have not beenrigorously evaluated, they can best be described asemerging or promising rather than best practices.Research in palliative care has been describedas small and descriptive, lacking the quality tocontribute to evidence-based medicine (2). Thisis partly due to the lack of dedicated researchfunding and academic positions in palliative care inmost countries in the European Region. There arealso challenges to conducting research on palliativecare, such as ethical concerns about placing anextra burden on the people needing care and theirfamilies and high attrition rates in longitudinalstudies due to deterioration in people’s condition.High-quality research is urgently needed onpalliative care in general and especially on palliativecare for older people. Given the limited healthbudgets in most countries, such research needs toinclude information on the cost–effectiveness oftreatment and services.In recent years, several research initiatives haveemerged in Europe and North America.• In Canada, Can$ 16.5 million was allocated to apalliative care initiative, with a substantial amountallocated to research grants. A specific palliativecare research panel has been established.• The United States of America has a NationalPalliative Care Research Center.• In the United Kingdom, the Department of Healthhas established a national framework for cancerresearch. The National Cancer Research Networkhas a group on clinical studies of palliative careto facilitate the development of new clinical trialsand funds, and the National Cancer ResearchInstitute has set up two supportive and palliativecare research collaboratives to foster morecollaboration and interdisciplinary work: CancerExperiences Collaborative (3) and COMPASSCollaborative (4).• In Europe, a European Association for PalliativeCare Research Network was established in 1996.The European Association for Palliative Care andthe International Association for Hospice andPalliative Care joined forces with other regionaland academic organisations to initiate a global48