Palliative care was first introduced in modern medicine over a century ago. It was dedicated to life-limiting illnesses only; especially, cancer. However, as the field of medicine evolved with new research being done, palliative care has become more extensive and now covers other diseases as well.

The need for palliative care


An estimated seven million out of 10 million people suffering from cancer and AIDS are not cured and die within a year after their diagnosis; 60% of survivors faced significant pain. In view of the rise of ageing populations and associated non-communicable diseases, the need for palliative care is projected to escalate by the next half century. An estimated 1200 million of people are aged 60 years and older by the year 2025, and by 2050 the number will increase to 2000 million. Additionally, by the year 2050, the incidence of cancer is expected to be more than double of the estimation of 24 million new cases of cancer per year.

The barriers impeding provision of palliative care


Despite the importance of palliative care, there are a few barriers that need to be broken down before any implementations can be done effectively.

1. Lack of awareness


There could be a lack of awareness among the community, healthcare personnel and policy makers. For the community, this may include not knowing how to seek proper palliative care. However, what is more concerning is the lack of awareness among healthcare personnel and policy makers, as they are the backbone of this field.

2. Misconceptions


There may be misconceptions among the public – not to palliative care itself – but to a palliative component or a related issue. For instance, the use of potent analgesics such as opioid is believed to lead to substance abuse among patients, although WHO had released a guideline for morphine and other strong opioids for almost 20 years now.

Solutions for effective palliative care


Decision makers globally should develop appropriate policies that integrate palliative care in healthcare systems and finance proper training for developing human resources. In fact, these policies should be able to strengthen and enable human resources in term of knowledge, and skills needed for implementation of palliative care.

Additionally, each country should ensure the drug availability and estimate the need for such drugs. An article published in 2007 suggested that a drug supply divided into 30% of immediate-release morphine, 60% of slow-release morphine, 5% of parenteral morphine, and 5% of other opioids.

Nonetheless, education still plays a significant role in ensuring efficient palliative care. The media should also give the target audience proper information and clear up any misconceptions regarding the care.

Proper integration in the medical curricula is vital in improving the knowledge and skills of healthcare personnel. A specialised programme should also be extended to produce more experts in this field. MIMS

Read More:
The rising demand for palliative care services in Malaysia
The role of pharmacists in palliative care
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Sources:
http://www.jpsmjournal.com/article/S0885-3924(07)00122-4/fulltext
http://www.who.int/mediacentre/factsheets/fs402/en/
http://medicine.emory.edu/ger/bibliographies/pallative/bibliography5_files/Barriers_to_effective_palliative_care_of_terminal_patients..pdf