The Pharmaceutical Journal
Vol 278 No 7455 p679-682
9 June 2007

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Pain in palliative care: a review

In the first of two articles on managing pain in palliative care, Andrew Dickman looks at non-opioid and adjuvant analgesics

Continuing professional development articles

Palliative care series

SUMMARY

Palliative care has traditionally been associated with the model of care introduced for cancer patients by hospices within the UK. The aim of palliative care is to relieve symptoms and enable a patient to die with dignity.

In 2002, the World Health Organization introduced a new definition of palliative care (see Panel).

This was an important development because the definition recognises that other life-threatening conditions are of equal concern and that palliative care is also applicable early in the course of an illness, and it encompasses the treatment of physical, psychological and spiritual needs of both the patient and his or her family.

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Panel 1: What is palliative care?

Palliative care is an approach that improves the quality of life of patients and their families facing problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.

Palliative care:

• Provides relief from pain and other distressing symptoms

• Affirms life and regards dying as a normal process

• Intends neither to hasten or postpone death

• Integrates the psychological and spiritual aspects of patient care

• Offers a support system to help patients live as actively as possible until death

• Offers a support system to help families cope during the patient’s illness and in their own bereavement

• Uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated

• Will enhance quality of life, and may also positively influence the course of illness

• Is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications