Integrated Palliative Care: Clinical, Organizational, and Health System Perspectives

Abstract

Various (integrated) service models of palliative care for both inpatient and community settings have been developed around the world. The importance of collaboration between palliative and respiratory medicine has been recognised in recent national and international guidance. However, specialist palliative care support for patients is still variable, with higher acceptance for patients with malignant lung disease and more sporadic access for patients with chronic, non-malignant lung disease. Barriers to access are related to disease trajectories, service configuration and delivery, and lack of training for both generalist and specialist palliative care. Access to palliative care is facilitated by systematic needs assessment and recognition of both disease-and symptom-related triggers to initiate palliative care.