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European palliative care guidelines: how well do they meet the needs of people with impaired cognition?

By:

Sampson, Elizabeth L

Publication details: 2015Uniform titles:

BMJ Supportive & Palliative Care

Online resources:

Summary: <h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;">OBJECTIVE:</h4>Numbers of people dying with cognitive impairment (intellectual disability (ID), dementia or delirium) are increasing. We aimed to examine a range of European national palliative care guidelines to determine if, and how well, pain detection and management for people dying with impaired cognition are covered.<h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;">METHODS:</h4>Questionnaires were sent to 14 country representatives of the European Pain and Impaired Cognition (PAIC) network who identified key national palliative care guidelines. Data was collected on guideline content: inclusion of advice on pain management, whether cognitively impaired populations were mentioned, assessment tools and management strategies recommended. Quality of guideline development was assessed with the Appraisal of Guidelines Research and Evaluation (AGREE) instrument.<h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;">RESULTS:</h4>11 countries identified palliative care guidelines, 10 of which mentioned pain management in general. Of these, seven mentioned cognitive impairment (3 dementia, 2 ID and 4 delirium). Half of guidelines recommended the use of pain tools for people with cognitive impairment; recommended tools were not all validated for the target populations. Guidelines from the UK, the Netherlands and Finland included most information on pain management and detection in impaired cognition. Guidelines from Iceland, Norway and Spain scored most highly on AGREE rating in terms of developmental quality.<h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;">CONCLUSIONS:</h4>European national palliative care guidelines may not meet the needs of the growing population of people dying with cognitive impairment. New guidelines should consider suggesting the use of observational pain tools for people with cognitive impairment. Better recognition of their needs in palliative care guidelines may drive improvements in care.

Holdings
Item type	Home library	Collection	Class number	Status	Date due	Barcode
Book	Ferriman information and Library Service (North Middlesex) Shelves	Staff publications for NMDX		Available

NMUH Staff Publications

<h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;">OBJECTIVE:</h4>Numbers of people dying with cognitive impairment (intellectual disability (ID), dementia or delirium) are increasing. We aimed to examine a range of&nbsp;European&nbsp;national&nbsp;palliative care&nbsp;guidelines&nbsp;to determine if, and how well, pain detection and management for people dying with impaired cognition are covered.<h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;">METHODS:</h4>Questionnaires were sent to 14 country representatives of the&nbsp;European&nbsp;Pain and Impaired Cognition (PAIC) network who identified key national&nbsp;palliative care&nbsp;guidelines. Data was collected on&nbsp;guideline&nbsp;content: inclusion of advice on pain management, whether cognitively impaired populations were mentioned, assessment tools and management strategies recommended. Quality of&nbsp;guideline&nbsp;development was assessed with the Appraisal of&nbsp;Guidelines&nbsp;Research and Evaluation (AGREE) instrument.<h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;">RESULTS:</h4>11 countries identified&nbsp;palliative care&nbsp;guidelines, 10 of which mentioned pain management in general. Of these, seven mentioned cognitive impairment (3 dementia, 2 ID and 4 delirium). Half of&nbsp;guidelines&nbsp;recommended the use of pain tools for people with cognitive impairment; recommended tools were not all validated for the target populations.&nbsp;Guidelines&nbsp;from the UK, the Netherlands and Finland included most information on pain management and detection in impaired cognition.&nbsp;Guidelines&nbsp;from Iceland, Norway and Spain scored most highly on AGREE rating in terms of developmental quality.<h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;">CONCLUSIONS:</h4>European&nbsp;national&nbsp;palliative care&nbsp;guidelines&nbsp;may not meet the needs of the growing population of people dying with cognitive impairment. New&nbsp;guidelines&nbsp;should consider suggesting the use of observational pain tools for people with cognitive impairment. Better recognition of their needs in&nbsp;palliative care&nbsp;guidelines&nbsp;may drive improvements in&nbsp;care.

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