Research and innovation
Palliative medicine is a relatively new specialty. Improvements are driven by seeking evidence for effectiveness, identifying deficits in treatments and striving to apportion resources fairly in order to deliver high-quality patient care. Evidence-based medicine is, therefore, the cornerstone of the specialty, using current best evidence to direct the treatment of the individual patient. The evidence base for palliative care is stronger in the UK than in most other countries although there are relatively few academic departments in palliative medicine. There have also been many palliative care studies which have been locally based or small in scale, and therefore difficult to generalise to the wider population. Multidisciplinary and multicentre collaboration is particularly helpful in providing useful palliative care research.
There are various ethical issues that pose particular problems for research in palliative care. Research on this group of vulnerable patients is difﬁcult, yet an evidence base in this clinical area is crucial. Research is also required on the efﬁcacy and cost-effectiveness of palliative care interventions, models of care and translational research.
Patient and Public Involvement (PPI) is growing in many parts of the NHS and social care, but has played a less consistent role in palliative and end-of-life care. This is partly because of the special challenges that involvement presents in this context. As palliative care research evolves, patients, carers and the public can contribute important expertise and help to ensure that research is of the highest value to inform services. Patient experience surveys or outcome reporting ensures that health and social care research is relevant to patients, the people using services and the public. Patients and carers often want to ‘give something back’ to the organisation or people who cared for them.
High-quality palliative care research is promoted through collaboration and dissemination of information through dedicated journals and conferences.
A biennial conference is co-hosted by the Association for Palliative Medicine (APM), the Palliative Care Research Society (PCRS) and the Royal College of Nursing Palliative Nursing Forum.
The Palliative Care Research Society (PCRS) holds an annual conference.
The Scottish Partnership for Palliative Care holds an annual conference and each year invites applications for poster presentations.
The APM science committee runs a training programme in critical appraisal and research methods for the specialty. Increasing numbers of specialty registrars and consultants in palliative medicine are achieving higher research degrees. A network of APM research champions supports new researchers across UK and Ireland.
Research is required in the efﬁcacy and cost-effectiveness of palliative care interventions, models of care and translational research. Use of new technology and telephone consultations can also help to provide the much-needed support and advice to patients and their families/carers.