Final Report Summary - EURO IMPACT (European Intersectorial and Multi-disciplinary Palliative Care Research Training) BACKGROUND Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness. It achieves this through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other physical, psychosocial and spiritual problems. While international research on palliative care has begun to develop over the past decades, it has not kept pace with the growing demand for high quality care. To meet the societal challenges accompanying the dramatic increase in patients facing the need for good palliative care in the coming decades, there is an urgent need for enhanced collaborative research training in palliative care. We need to provide the current and the next generation of researchers with the best possible skills to improve evidence based palliative care and influence palliative care policies at national and international level.OBJECTIVES The general aim of the Marie Curie Initial Training Network EURO IMPACT (2010-2014) –European Intersectorial and Multi-disciplinary Palliative Care Research Training– is to develop a multi-disciplinary, multi-professional and intersectorial educational and research training framework on palliative care in Europe. More specifically, EURO IMPACT trains an international pool of researchers to master:- scientific skills in palliative care research, via a research programme aimed at describing and monitoring palliative care and its quality across Europe and identifying and evaluating tools to improve care; - skills in societal dissemination techniques i.e. translating research results into clinical practice and policy, by bridging the gap between academic and non-academic sectors within the wider EU community.EURO IMPACT will:- bridge the gap between individual research institutes, multiple disciplines and different sectors involved in palliative care research training in Europe. Cross-fertilization of currently dispersed research activities will reduce the fragmentation of a topic of great EU relevance- build the basis for the further development of a EU platform for palliative care PhD research training- increase the international mobility of palliative care researchers across Europe. Hence, Europe will benefit from a new generation of researchers who will have an increased cross-national impact on the development of palliative care (research) policies.CONSORTIUM The consortium of EURO IMPACT represents a broad array of disciplines, professions, research domains and sectors – academia and non-academic sectors – involved in palliative care in Europe. The training and research programme of EURO IMPACT is closely intertwined, involving 5 universities, 1 private charity/company (SME), 1 private company and 4 other socio-economic actors, and training 12 junior researchers (for three years each) and 4 experienced researchers (for 18 months each) coming from different parts of the world. RESEARCH STUDIES The researchers have been working on individual research projects within four closely related research programmes. They have worked together and have been exposed to different research methodologies and datasets gathered in different countries and from multiple perspectives. The first research programme provides an overall picture of palliative care provision in Europe. Existing individual country reports concerning the development of palliative care have been critically reviewed and the reports from resource poor countries are being updated.The second research programme provides an empirical overview of palliative care and its quality in Europe for different subgroups of patients. Over the past EURO IMPACT period, the consortium has performed a number of systematic literature reviews, analyzed retrospective cross-national data gathered from representative GP networks, and analyzed prospective trial data gathered in hospitals and palliative care units across different countries in Europe, resulting in the identification of important areas in which there is considerable room for improvement of the care provided at the end of life. While palliative care has been advocated by the World Health Organisation for all people with life-threatening diseases and early in the disease course, current data show that palliative care is not always provided in this manner for cancer and particularly for non-cancer patients, such as elderly people and people dying with dementia.The third research programme identified tools to improve palliative care in Europe. Results from EURO IMPACT underline the importance of developing and validating quality indicators for palliative care focusing on physical as well as psychosocial and spiritual patient outcomes, as a tool to improve quality of care of palliative care providers. Additionally, the research shows that the use of computers to measure these patient outcomes appears feasible and has positive effects in advanced cancer patients.The fourth research programme provides societal dissemination tools that can be useful for guiding practice and policy. It provides tools for better outcomes assessment in palliative care, and has produced important policy recommendations for the integration of palliative care in mainstream health and social care and related policies in Europe. Based on contributions from authors all over the world, Oxford University Press will publish in 2015 the book “Palliative care for older people: a public health perspective” by EURO IMPACT. This book uses a public health perspective as the ageing of our society poses challenges to social and health care structures in many countries. This book demonstrates the added value of palliative care, outlines the current state of worldwide policy work, research and innovations and concludes with advice for policy- and decision-makers to improve access to and quality of palliative care for older people.The project consortium has consequently developed a set of policy recommendations for policy, practice and research which are integrated in the 2014 European Declaration on Palliative Care (http://palliativecare2020.eu/declaration/ ), launched at the closing conference on October 15, 2014 in Brussels.All outcomes of the project are listed on the EURO IMPACT website www.euro-impact.eu including international and national publications, presentations at conferences or other dissemination activities to a wider national and international audience. TRAINING The training programme of EURO IMPACT has been multi-disciplinary, multi-professional, international and intersectorial and provided the next generation of European researchers with the necessary scientific and complementary skills to influence future palliative care. In order for palliative care researchers to excel and have the best possible career prospects, they needed to develop relevant skills beyond the academic. Learning goals within EURO IMPACT concerned competences in different palliative care research methodologies, multidisciplinarity, ethics, cross-country comparisons, understanding palliative care concepts, service development, translation of research into practice and policy, presentation and writing for different audiences, and the development of organizational, collaboration and networking skills.The researchers benefited from on-the-job research training, supplemented with existing structured training courses and newly developed network-wide trainings to exploit the expertise of each partner. Additionally, researchers visited and were seconded to different partners and between sectors during their trajectory increasing their mobility within the EU. While most training trajectories have been the same for all researchers, each individual researcher has set up a personal career development plan, depending on their needs and on his/her individual project, including training, research and secondment plans. Within the entire EURO IMPACT period, all research fellows have been enrolled in the 11 structured training courses provided within the project. An overview of the courses can be found on the EURO IMPACT website: http://www.endoflifecare.be/euroimpact/training-courses. The consortium has organised 7 network-wide trainings for the researchers, of which most were attended by external researchers from outside this project. Site visits were organized by the European Union Geriatric Medicine Society, the Palliative Care Research Center (Norway), and Cicely Saunders International (UK) to learn from, and network with, non-academic sectors and clinical practice. Secondments to partnering institutes were completed for all researchers in the project.CONCLUSION EURO IMPACT has successfully trained palliative care researchers within a European network of centres of excellence in palliative care research training, establishing a new generation of European researchers with the necessary skills to influence future palliative care policies and practice. EURO IMPACT has laid the foundation for the development of an European network of excellence of PhD research training.
