Palliative Care in the Global Setting

Overview

This resource-stratified practice guideline from the American Society of Clinical Oncology (ASCO) gives clinicians and policymakers guidance on providing palliative care to patients with cancer and their caregivers where resources are limited. It complements ASCO's guideline on integrating palliative care into standard oncology care and is meant to complement, not replace, local guidelines.

How it was developed

ASCO convened a multinational panel covering medical and radiation oncology, haematology, family medicine, palliative and hospice care, symptom management, patient advocacy, public health and health economics. Development combined a systematic literature review, a modified ADAPTE process and a formal consensus process with an extended group of experts. Direct evidence was limited for many questions, so the recommendations rely substantially on expert consensus.

Resource stratification

Recommendations are tailored to different levels of health-system resources. ASCO advises that providers and decision-makers follow the recommendations for the highest resource level actually available to them.

What the recommendations cover

The guideline defines models of palliative care delivery, staffing requirements, and the roles and training needs of team members across resource settings. It also sets standards for psychosocial support, spiritual care and access to opioid analgesics for pain relief, areas that are often challenging and overlooked where resources are constrained.

Why it matters

A large share of people who die from cancer live in countries where access to palliative care and pain relief is limited. By linking each recommendation to the resources actually available, the guideline gives planners a realistic way to start or expand services and improve them step by step.

Who it is for

Oncologists, palliative care teams, family physicians, nurses, health-system planners and policymakers, especially in low- and middle-income countries.