Advertisement

Organization of Palliative Care in Different Parts of the World

  • Carlos Centeno
  • John Y. Rhee
Living reference work entry

Abstract

Palliative care has developed rapidly and heterogeneously in the past decade around the globe. In this chapter, we present an overview of palliative care development in different regions of the world with a pair of case studies of models of palliative care delivery within each region. The textbook is divided into subsections based on the following regions: Europe, North America, Latin America, Africa, Asia-Pacific, and Middle East. Regions were decided based on existing palliative care networks, where available. Information regarding palliative care development in each region is organized based on the World Health Organization’s Public Health Strategy for Palliative Care: (1) policies, (2) medicine availability, (3) education, and (4) implementation of services plus (5) vitality (professional activity). This chapter is intended for the reader to gain a high-level view of the state of palliative care development in regions of the world and the challenges and successes within each region. Two case models per region give the reader a quick view into the diversity of palliative care services offered in different regions of the world and give the reader insight into regional-specific delivery models.

Notes

Acknowledgments

We would like to thank the following people for reviewing each subsection and/or case model of the textbook.

Liliana de Lima

International Association for Hospice and Palliative Care

United States of America

Diane Meier

Center to Advance Palliative Care

United States of America

Nahla Gafer & Shaima Sideeg

Radiation and Isotope Center Khartoum

Sudan

Eduardo Mario Mutto

Hospital Universitario Austral

Argentina

Eduardo Garralda

Institute for Culture and Society

University of Navarra

Spain

Hibah Osman

Balsam Center

Lebanon

Ednin Hamzah

Hospis Malaysia

Malaysia

Asia Pacific Hospice Palliative Care Network

Jose Pereira

Pallium Canada

Canada

Young Seon Hong

Advisory Council

Asia Pacific Hospice Palliative Care Network

Javier Rocafort Gil

Laguna Centro de Cuidados

Spain

José Mario López Saca

Clínica de Cuidados Paliativos

El Salvador

Omar Shamieh

Jordan Nat’l Pain & Palliative Care Committee

Ministry of Health

King Hussein Cancer Center

Jordan

Emmanuel Luyirika

African Palliative Care Association

Uganda

 

References

  1. Abdel-Wahab M, Bourque JM, Pynda Y, Izewska J, Van der Merwe D, Zubizarreta E, Rosenblatt E. Status of radiotherapy resources in Africa: an International Atomic Energy Agency analysis. Lancet Oncol. 2013;14(4):e168–75.  https://doi.org/10.1016/S1470-2045(12)70532-6.CrossRefPubMedGoogle Scholar
  2. African Palliative Care Association. Consensus statement for palliative care integration into health systems in Africa: Palliative Care for Africa. 2013. http://www.thewhpca.org/images/resources/advocacy/Kampala_Declaration_on_Palliative_Care_Final.pdf
  3. African Palliative Care Association. Consensus statement for strengthening palliative care as a component of comprehensive care throughout the life course in Africa – “The Kampala Declaration 2016”. Kampala; 2016a. Retrieved from http://www.thewhpca.org/resources/item/the-kampala-declaration-2016.
  4. African Palliative Care Association. Review of the status of palliative care in ten southern African countries. Kampala: African Palliative Care Association; 2016b. Retrieved from https://www.africanpalliativecare.org/images/stories/pdf/REVIEW_OF_THE_STATUS_OF_PALLIATIVE_CARE%20IN_TEN_SOUTHERN_AFRICAN_COUNTRIES_Report.pdf.
  5. Aldridge MD, Hasselaar J, Garralda E, van der Eerden M, Stevenson D, McKendrick K, … Meier DE. Education, implementation, and policy barriers to greater integration of palliative care: a literature review. Palliat Med. 2016;30(3):224–39.  https://doi.org/10.1177/0269216315606645.CrossRefGoogle Scholar
  6. Al-Shahri MZ. Cancer pain: progress and ongoing issues in Saudi Arabia. Pain Res Manag. 2009;14(5):359–60.PubMedPubMedCentralGoogle Scholar
  7. Asia Pacific Hospice Palliative Care Network (Producer). 15th Anniversary special issue. Newsletter Issues. October 17, 2016. Retrieved from https://gallery.mailchimp.com/71e579820cfca9226d20e3fca/files/Issue_20_15th_Anniversary.compressed.pdf.
  8. Bolognesi D, Centeno C, Biasco G. Specialisation in palliative medicine for physicians in Europe 2014 – a supplement of the EAPC atlas of palliative care in Europe. 2014. Retrieved from Milan. http://www.eapcnet.eu/Portals/0/Organization/Development%20in%20Europe%20TF/Specialisation/2014_SpecialisationPMPhysicianInEurope.pdf
  9. Bruera E. Palliative care in Latin America. J Pain Symptom Manag. 1993;8(6):365–8.CrossRefGoogle Scholar
  10. Bruera E, Neumann CM, Gagnon B, Brenneis C, Kneisler P, Selmser P, Hanson J. Edmonton Regional Palliative Care Program: impact on patterns of terminal cancer care. CMAJ. 1999;161(3):290–3.PubMedPubMedCentralGoogle Scholar
  11. Canadian Hospice Palliative Care Association. 2016. Retrieved from http://www.chpca.net/about_us/history.html.
  12. Canadian Medical Association. Palliative care: Canadian Medical Association’s national call to action. 2015. Retrieved from Ottawa. https://www.cma.ca/Assets/assets-library/document/en/advocacy/palliative-care-report-online-e.pdf
  13. Canadian Society of Palliative Care Physicians. History & accomplishments. 2014. Retrieved from http://www.cspcp.ca/about/history/.
  14. Carrasco JM, Lynch TJ, Garralda E, Woitha K, Elsner F, Filbet M, … Centeno C. Palliative care medical education in European universities: a descriptive study and numerical scoring system proposal for assessing educational development. J Pain Symptom Manage. 2015;50(4):516–23 e512.  https://doi.org/10.1016/j.jpainsymman.2015.04.019.CrossRefGoogle Scholar
  15. Centeno C, Garralda E. Integrated Palliative Care.Chapter 2: Public health opportunities to improve pallitaive care integration across Europe. Nijmegen: Radboud University Medical Center; 2016.Google Scholar
  16. Centeno C, Clark D, Lynch T, Racafort J, Praill D, De Lima L, … Force ET. Facts and indicators on palliative care development in 52 countries of the WHO European region: results of an EAPC Task Force. Palliat Med. 2007;21(6):463–71.  https://doi.org/10.1177/0269216307081942.CrossRefGoogle Scholar
  17. Centeno C, Lynch T, Donea O, Rocafort J, Clark D. EAPC atlas of palliative care in Europe 2013. Cartographic Edition. 2013a. Retrieved from Milan.Google Scholar
  18. Centeno C, Lynch T, Donea O, Rocafort J, Clark D. EAPC atlas of palliative care in Europe 2013. Full Edition. 2013b. Retrieved from Milan.Google Scholar
  19. Centeno C, Bolognesi D, Biasco G. Comparative analysis of specialization in palliative medicine processes within the World Health Organization European region. J Pain Symptom Manag. 2015;49(5):861–70.  https://doi.org/10.1016/j.jpainsymman.2014.10.019.CrossRefGoogle Scholar
  20. Centeno C, Lynch T, Garralda E, Carrasco JM, Guillen-Grima F, Clark D. Coverage and development of specialist palliative care services across the World Health Organization European Region (2005–2012): results from a European Association for Palliative Care Task Force survey of 53 countries. Palliat Med. 2016;30(4):351–62.  https://doi.org/10.1177/0269216315598671.CrossRefPubMedGoogle Scholar
  21. Center to Advance Palliative Care. About the Center to Advance Palliative Care. 2017. Retrieved from https://www.capc.org/about/capc/.
  22. Centers for Disease Control and Prevention. Injury prevention & control: opioid overdose. 2016. Retrieved from https://www.cdc.gov/drugoverdose/data/prescribing.html.
  23. Cherny NI, Baselga J, de Conno F, Radbruch L. Formulary availability and regulatory barriers to accessibility of opioids for cancer pain in Europe: a report from the ESMO/EAPC Opioid Policy Initiative. Ann Oncol. 2010;21(3):615–26.  https://doi.org/10.1093/annonc/mdp581.CrossRefPubMedGoogle Scholar
  24. Cleary J, De Lima L, Eisenchlas J, Radbruch L, Torode J, Cherny NI. Formulary availability and regulatory barriers to accessibility of opioids for cancer pain in Latin America and the Caribbean: a report from the Global Opioid Policy Initiative (GOPI). Ann Oncol. 2013a;24(Suppl 11):xi41–50.  https://doi.org/10.1093/annonc/mdt502.CrossRefPubMedGoogle Scholar
  25. Cleary J, Powell RA, Munene G, Mwangi-Powell FN, Luyirika E, Kiyange F, … Cherny NI. Formulary availability and regulatory barriers to accessibility of opioids for cancer pain in Africa: a report from the Global Opioid Policy Initiative (GOPI). Ann Oncol. 2013b;24(Suppl 11):xi14–23.  https://doi.org/10.1093/annonc/mdt499.CrossRefGoogle Scholar
  26. Cleary J, Radbruch L, Torode J, Cherny NI. Formulary availability and regulatory barriers to accessibility of opioids for cancer pain in Asia: a report from the Global Opioid Policy Initiative (GOPI). Ann Oncol. 2013c;24(Suppl 11):xi24–32.  https://doi.org/10.1093/annonc/mdt500.CrossRefPubMedGoogle Scholar
  27. Cleary J, Silbermann M, Scholten W, Radbruch L, Torode J, Cherny NI. Formulary availability and regulatory barriers to accessibility of opioids for cancer pain in the Middle East: a report from the Global Opioid Policy Initiative (GOPI). Ann Oncol. 2013d;24(Suppl 11):xi51–9.  https://doi.org/10.1093/annonc/mdt503.CrossRefPubMedGoogle Scholar
  28. Connor SR. Development of hospice and palliative care in the United States. Omega (Westport). 2007;56(1):89–99.CrossRefGoogle Scholar
  29. Council of Europe. Recommendation Rec (2003) 24 of the Committee of Ministers to member states on the organisation of palliative care. 2003. Retrieved from https://wcd.coe.int/ViewDoc.jsp?id=85719.
  30. Covenant Health. PC matters: building national consensus. 2017. Retrieved from http://www.palliativecarematters.ca/home/.
  31. Di Sorbo PG, Chifamba DD, Mastrojohn J 3rd, Sisimayi CN, Williams SH. The Zimbabwe Rural Palliative Care Initiative: PCI-Z. J Pain Symptom Manag. 2010;40(1):19–22.  https://doi.org/10.1016/j.jpainsymman.2010.04.005.CrossRefGoogle Scholar
  32. Dickinson GE. A 40-year history of end-of-life offerings in US medical schools: 1975–2015. Am J Hosp Palliat Care. 2016.  https://doi.org/10.1177/1049909116638071.
  33. Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain – United States, 2016. Morb Mortal Wkly Rep. 2016;65(1):1–49.CrossRefGoogle Scholar
  34. Dumanovsky T, Augustin R, Rogers M, Lettang K, Meier DE, Morrison RS. The growth of palliative care in U.S. hospitals: a status report. J Palliat Med. 2016;19(1):8–15.  https://doi.org/10.1089/jpm.2015.0351.CrossRefPubMedPubMedCentralGoogle Scholar
  35. El servicio de Cuidados Paliativos ha atendido casi 15.000 llamadas este año [Press release]. 2013. Retrieved from http://www.madrid.org/cs/Satellite?cid=1354287017608&language=es&pageid=1159444389315&pagename=PortalSalud%2FCM_Actualidad_FA%2FPTSA_pintarActualidad&vest=1159444389315.
  36. Ens CD, Chochinov HM, Gwyther E, Moses S, Jackson C, Thompson G, Harding R. Postgraduate palliative care education: evaluation of a South African programme. S Afr Med J. 2011;101(1):42–4.CrossRefGoogle Scholar
  37. European Association for Palliative Care. National palliative care associations in Europe. 2016. Retrieved from http://www.eapcnet.eu/Home.aspx.
  38. Fainsinger RL, Brenneis C, Fassbender K. Edmonton, Canada: a regional model of palliative care development. J Pain Symptom Manag. 2007;33(5):634–9.  https://doi.org/10.1016/j.jpainsymman.2007.02.012.CrossRefGoogle Scholar
  39. Gafer N, Elhaj A. Palliative care for cancer patients in Sudan: an overview. Ecancermedicalscience. 2014;8:491.  https://doi.org/10.3332/ecancer.2014.491.CrossRefPubMedPubMedCentralGoogle Scholar
  40. Gelfman LP, Du Q, Morrison RS. An update: NIH research funding for palliative medicine 2006 to 2010. J Palliat Med. 2013;16(2):125–9.  https://doi.org/10.1089/jpm.2012.0427.CrossRefPubMedPubMedCentralGoogle Scholar
  41. Gilson AM, Maurer MA, Ryan KM, Rathouz PJ, Cleary JF. Using a morphine equivalence metric to quantify opioid consumption: examining the capacity to provide effective treatment of debilitating pain at the global, regional, and country levels. J Pain Symptom Manag. 2013;45(4):681–700.  https://doi.org/10.1016/j.jpainsymman.2012.03.011.CrossRefGoogle Scholar
  42. Goh CR. The Asia Pacific Hospice Palliative Care Network: a network for individuals and organizations. J Pain Symptom Manag. 2002;24(2):128–33.CrossRefGoogle Scholar
  43. Hamzah E. Hospis Malaysia/Interviewer: J. Rhee. November 23, 2016.Google Scholar
  44. Harding R, Selman L, Powell RA, Namisango E, Downing J, Merriman A, … Higginson I. Research into palliative care in sub-Saharan Africa. Lancet Oncol. 2013;14(4):e183–8.  https://doi.org/10.1016/S1470-2045(12)70396-0.
  45. Health T. R. o. U. M. o. National palliative care policy. Kampala; 2015. The Republic of Uganda Ministry of HealthGoogle Scholar
  46. Hegarty M, Breaden K, Agar M, Devery K, Goh C, Shaw R, … Currow DC. Asia Pacific palliative care development through education. J Pain Symptom Manag. 2014;47(2):e7–9.  https://doi.org/10.1016/j.jpainsymman.2013.11.006.
  47. Hospice Africa Uganda. 2016a. Retrieved from http://www.hospiceafrica.or.ug/index.php/about-us.
  48. Hospice Africa Uganda. Education. 2016b. Retrieved from http://www.hospiceafrica.or.ug/index.php/education.
  49. Hospice Casa Sperantei. 2015 Annual report. 2016. Retrieved from http://www.hospice.ro/media/2016/08/HCS_Raport-Anual-2015_online.pdf.
  50. Human Rights Watch. Ending needless suffering in Francophone Africa. 2015. Retrieved from https://www.hrw.org/news/2015/10/09/ending-needless-suffering-francophone-africa.
  51. International Narcotics Control Board. Report of the International Narcotics Control Board for 2015. 2015. Retrieved from https://www.incb.org/incb/en/publications/annual-reports/annual-report-2015.html.
  52. Jagwe J, Merriman A. Uganda: delivering analgesia in rural Africa: opioid availability and nurse prescribing. J Pain Symptom Manag. 2007;33(5):547–51.  https://doi.org/10.1016/j.jpainsymman.2007.02.014.CrossRefGoogle Scholar
  53. Kumar SK. Kerala, India: a regional community-based palliative care model. J Pain Symptom Manag. 2007;33(5):623–7.  https://doi.org/10.1016/j.jpainsymman.2007.02.005.CrossRefGoogle Scholar
  54. Lien Collaborative for Palliative Care. Documentary reveals the challenges and triumphs of bringing palliative care to parts of Asia & how pain relief eludes the dying [Press release]. October 8, 2016. Retrieved from http://lifeaskeddeath.com/downloads/Life-Asked-Death_Press-Release_6-Oct-2016.pdf.
  55. López Saca JM. Interview/Interviewer: J. Rhee. December 28, 2016.Google Scholar
  56. Loucka M, Payne S, Brearley S. Measuring the Development of Palliative Care Across the World: Methodological Challenges, 2012. International Palliative Care Network Lecture Series 2012Google Scholar
  57. Lupu D, American Academy of Hospice and Palliative Medicine Workforce Task Force. Estimate of current hospice and palliative medicine physician workforce shortage. J Pain Symptom Manag. 2010;40(6):899–911.  https://doi.org/10.1016/j.jpainsymman.2010.07.004.CrossRefGoogle Scholar
  58. Lustbader D, Mudra M, Romano C, Lukoski E, Chang A, Mittelberger J, … Cooper D. The impact of a home-based Palliative Care Program in an Accountable Care Organization. J Palliat Med. 2016.  https://doi.org/10.1089/jpm.2016.0265.
  59. Luyirika EB, Namisango E, Garanganga E, Monjane L, Ginindza N, Madonsela G, Kiyange F. Best practices in developing a national palliative care policy in resource limited settings: lessons from five African countries. Ecancermedicalscience. 2016;10:652.  https://doi.org/10.3332/ecancer.2016.652.CrossRefPubMedPubMedCentralGoogle Scholar
  60. Lynch T, Connor S, Clark D. Mapping levels of palliative care development: a global update. J Pain Symptom Manag. 2013;45(6):1094–106.  https://doi.org/10.1016/j.jpainsymman.2012.05.011.CrossRefGoogle Scholar
  61. Merino MTG-B. PAL24, el modelo de atención integral y continuada de los pacientes de Cuidados Paliativos en Madrid [Press release]. 2016. Retrieved from http://isanidad.com/69478/pal24-el-modelo-de-atencion-integral-y-continuada-de-los-pacientes-de-cuidados-paliativos-en-madrid/.
  62. Mpanga Sebuyira L, Mwangi-Powell F, Pereira J, Spence C. The Cape Town palliative care declaration: home-grown solutions for sub-Saharan Africa. J Palliat Med. 2003;6(3):341–3.  https://doi.org/10.1089/109662103322144646.CrossRefPubMedGoogle Scholar
  63. Mutto EM. Unidad de Cuidados Palitivos del Hospital Universitario Austral/Interviewer: J. Rhee. December 14, 2016.Google Scholar
  64. National Cancer Institute. Palliative care in cancer. 2010. Retrieved from https://www.cancer.gov/about-cancer/advanced-cancer/care-choices/palliative-care-fact-sheet.
  65. National Coalition for Hospice and Palliative Care. About us. 2017. Retrieved from http://www.nationalcoalitionhpc.org/DisplayPage.aspx?Title=Welcome!.
  66. National Hospice and Palliative Care Organization. History of hospice care. 2015a. Retrieved from http://www.nhpco.org/history-hospice-care.
  67. National Hospice and Palliative Care Organization. NHPCO’s facts and figures: hospice care in America. 2015b. Retrieved from http://www.nhpco.org/sites/default/files/public/Statistics_Research/2015_Facts_Figures.pdf.
  68. National Palliative Care Research Center. 2013. Retrieved from http://www.npcrc.org/.
  69. Osman H. Development of palliative care in Lebanon. Obstacles and opportunities. J Med Liban. 2015a;63(1):42–6.PubMedGoogle Scholar
  70. Osman H. The Lebanese Center for Palliative Care – Balsam: annual report 2015. 2015b. Retrieved from Beirut. http://balsam-lb.org/wp-content/uploads/2018/01/5th-Balsam-Annual-report-2015.pdf
  71. Osman H. Palliative care development in the WHO EMRO/Interviewer: J. Rhee. December 10, 2015. 2016.Google Scholar
  72. Osman H, Rihan A, Garralda E, Rhee JY, Pons JJ, de Lima L, Tfayli A, Centeno C. Atlas of Palliative Care Development in the Eastern Mediterranean Region (EMRO). (2017) IAHPC Press. https://dadun.unav.edu/handle/10171/43303
  73. Pain and Policy Studies Group. Country profiles. 2014a. Retrieved from http://www.painpolicy.wisc.edu/country/profile/united-states-america.
  74. Pain and Policy Studies Group. WHO Regional Office for Africa (AFRO). 2014b. Retrieved from http://www.painpolicy.wisc.edu/who-regional-office-africa-afro.
  75. Pain and Policy Studies Group. WHO Regional Office for the Americas (AMRO). 2014c. Retrieved from http://www.painpolicy.wisc.edu/amro-0.
  76. Pain and Policy Studies Group. WHO Regional Office for the Eastern Mediterranean (EMRO). 2014d. Retrieved from http://www.painpolicy.wisc.edu/who-regional-office-eastern-mediterranean-emro.
  77. Pain and Policy Studies Group. WHO Regional Office for the Western Pacific (WPRO). 2014e. Retrieved from http://www.painpolicy.wisc.edu/who-regional-office-western-pacific-wpro.
  78. Pallium Canada. About us. 2017. Retrieved from www.pallium.ca.
  79. Pastrana T, De Lima L, Wenk R, Eisenchlas J, Monti C, Rocafort J, Centeno C. Atlas de Cuidados Paliativos de Latinoamérica. 2012. Retrieved from Houston http://cuidadospaliativos.org/publicaciones/atlas-de-cp-de-latinoamerica/.
  80. Pastrana T, Centeno C, De Lima L. Palliative care in Latin America from the professional perspective: a SWOT analysis. J Palliat Med. 2015;18(5):429–37.  https://doi.org/10.1089/jpm.2014.0120.CrossRefPubMedGoogle Scholar
  81. Patient Quality of Life Coalition. About PQLC. 2017. Retrieved from http://patientqualityoflife.org/about-pqlc/.
  82. Radbruch L, Foley K, De Lima L, Praill D, Furst CJ. The Budapest Commitments: setting the goals a joint initiative by the European Association for Palliative Care, the International Association for Hospice and Palliative Care and Help the Hospices. Palliat Med. 2007;21(4):269–71.  https://doi.org/10.1177/0269216307080189.CrossRefPubMedGoogle Scholar
  83. Rawlinson F, Luyirika E. Collaboration across continents to produce e-learning for palliative care education in Sub Saharan Africa. Ecancermedicalscience. 2014;8:ed36.  https://doi.org/10.3332/ecancer.2014.ed36.CrossRefPubMedPubMedCentralGoogle Scholar
  84. Rawlinson F, Gwyther L, Kiyange F, Luyirika E, Meiring M, Downing J. The current situation in education and training of health-care professionals across Africa to optimise the delivery of palliative care for cancer patients. Ecancermedicalscience. 2014;8:492.  https://doi.org/10.3332/ecancer.2014.492.CrossRefPubMedPubMedCentralGoogle Scholar
  85. Rhee JY, Luyirika E, Namisango E, Powell RA, Garralda E, Pons JJ, de Lima L, Centeno C. APCA Atlas of Palliative Care Development in Africa. (2017) IAHPC Press. https://www.africanpalliativecare.org/articles/apca-atlas-of-palliative-care-in-africa/
  86. Shamieh O. Palliative care in North Africa and the Middle East: Jordan perspectives. 2016. Retrieved from https://eapcnet.wordpress.com/2016/05/18/palliative-care-in-north-africa-and-the-middle-east-jordan-perspectives/.
  87. Shamieh O. King Hussein Cancer Center/Interviewer: J. Rhee. January 3, 2017.Google Scholar
  88. Shamieh O, Hui D. A comprehensive palliative care program at a tertiary cancer center in Jordan. Am J Hosp Palliat Care. 2015;32(2):238–42.  https://doi.org/10.1177/1049909113513316.CrossRefPubMedGoogle Scholar
  89. Shamieh O, Jazieh AR, MENA Cancer Palliative Care Regional Guidelines Committee. Modification and implementation of NCCN guidelines on palliative care in the Middle East and North Africa region. J Natl Compr Cancer Netw. 2010;8(Suppl 3):S41–7.CrossRefGoogle Scholar
  90. Shamieh O, Khamash O, Khraisat M, Jbouri O, Awni M, Al-Hawamdeh A, … Hui D. Impact of outpatient palliative care (PC) on symptom burden in patients with advanced cancer at a tertiary cancer center in Jordan. Support Care Cancer. 2017;25(1):177–83.  https://doi.org/10.1007/s00520-016-3395-8.CrossRefGoogle Scholar
  91. Silbermann M, Arnaout M, Daher M, Nestoros S, Pitsillides B, Charalambous H, … Oberman A. Palliative cancer care in Middle Eastern countries: accomplishments and challenges. Ann Oncol. 2012;23(Suppl 3):15–28.  https://doi.org/10.1093/annonc/mds084.CrossRefGoogle Scholar
  92. Silbermann M, Daher M, Fahmi-Abdalla R, Jaloudi MA, Hassan AA. The Middle East Cancer Consortium promotes palliative care. Lancet. 2015a;385(9978):1620–1.  https://doi.org/10.1016/S0140-6736(15)60791-7.CrossRefPubMedGoogle Scholar
  93. Silbermann M, Fink RM, Min SJ, Mancuso MP, Brant J, Hajjar R, … Strode D. Evaluating palliative care needs in Middle Eastern countries. J Palliat Med. 2015b;18(1):18–25.  https://doi.org/10.1089/jpm.2014.0194.CrossRefGoogle Scholar
  94. Sixty-seventh World Health Assembly. Strengthening of palliative care as a component of comprehensive care throughout the life course. Geneva. May 24, 2014. Retrieved from http://apps.who.int/gb/ebwha/pdf_files/WHA67/A67_R19-en.pdf.
  95. Stjernsward J, Foley KM, Ferris FD. The public health strategy for palliative care. J Pain Symptom Manag. 2007;33(5):486–93.  https://doi.org/10.1016/j.jpainsymman.2007.02.016.CrossRefGoogle Scholar
  96. The Association of Faculties of Medicine of Canada. Educating future physicians in palliative and end-of-life care. 2008. Retrieved from Ottawa https://afmc.ca/pdf/Educating%20Future%20Physicians%20in%20Palliative%20and%20End-of-Life%20Care-e.pdf.
  97. The Economist Intelligence Unit. The 2015 Quality of Death Index. 2015. Retrieved from http://www.eiuperspectives.economist.com/sites/default/files/2015%20EIU%20Quality%20of%20Death%20Index%20Oct%2029%20FINAL_0.pdf
  98. WHPCA, WHO. Global atlas of palliative care. 2014. Retrieved from http://www.who.int/nmh/Global_Atlas_of_Palliative_Care.pdf.
  99. Wilby KJ, Wilbur K. Cross-national analysis of estimated narcotic utilization for twelve Arabic speaking countries in the Middle East. Saudi Pharm J. 2017;25(1):83–87.CrossRefGoogle Scholar
  100. Williams AM, Crooks VA, Whitfield K, Kelley ML, Richards JL, DeMiglio L, Dykeman S. Tracking the evolution of hospice palliative care in Canada: a comparative case study analysis of seven provinces. BMC Health Serv Res. 2010;10:147.  https://doi.org/10.1186/1472-6963-10-147.CrossRefPubMedPubMedCentralGoogle Scholar
  101. Woitha K, Carrasco JM, Clark D, Lynch T, Garralda E, Martin-Moreno JM, Centeno C. Policy on palliative care in the WHO European region: an overview of progress since the Council of Europe’s (2003) recommendation 24. Eur J Pub Health. 2016a;26(2):230–5.  https://doi.org/10.1093/eurpub/ckv201.CrossRefGoogle Scholar
  102. Woitha K, Garralda E, Martin-Moreno JM, Clark D, Centeno C. Ranking of palliative care development in the countries of the European Union. J Pain Symptom Manag. 2016b;52(3):370–7.  https://doi.org/10.1016/j.jpainsymman.2016.03.008.CrossRefGoogle Scholar
  103. Yamaguchi T, Kuriya M, Morita T, Agar M, Choi YS, Goh C, … Tsuneto S. Palliative care development in the Asia-Pacific region: an international survey from the Asia Pacific Hospice Palliative Care Network (APHN). BMJ Support Palliat Care. 2014.  https://doi.org/10.1136/bmjspcare-2013-000588.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.ATLANTES Research ProgramInstitute for Culture and Society, University of NavarraPamplonaSpain
  2. 2.Palliative Care UnitClínica Universidad de Navarra, University of NavarraPamplonaSpain
  3. 3.Icahn School of Medicine at Mount SinaiNew YorkUSA

Personalised recommendations