Integration of palliative care in the management of multiple chronic conditions: An expert consensus paper with policy implications

Abstract

Background: This paper was jointly developed from members of the American Academy of Nursing Expert Panels on Palliative and End of Life Care, Primary Care, Aging, Acute and Critical Care, and two expert physicians.

Purpose: The overarching goal is to promote the integration of palliative care as symptom management into the primary care setting to transform care for patients living with multiple chronic conditions.

Methods: Embracing the recommendations made by the World Health Organization, the U.S. Department of Health and Human Services, and the National Academies of Science Engineering and Medicine to initiate palliative care or symptom management at the onset of nonreversible or serious chronic conditions.

Discussion: Earlier palliative interventions reduce disease exacerbation, prevent hospitalization, maintain physical functioning, and support health-related quality of life.

Conclusion: This is a needed paradigm shift as the nation's aging population escalates, Americans are living longer, and the healthcare costs for the nation are unprecedented.

Keywords: Disease exacerbation; Multiple chronic conditions; Palliative care; Patient-centered care; Physical functioning; Quality of life; Symptom management.