The news comes as the Designated Centre distinction is awarded to 142 centres this year, bringing the total to 200 from 42 countries.3 Nine Palliative Care Fellowships4 will also be bestowed, providing an intensive period of observation or research at an ESMO Designated Centre.
The ESMO Designated Centres programme is the premier initiative worldwide championing integrated programmes in oncology and palliative care, aiming to ease the physical and mental suffering of cancer patients during anticancer treatment and also at the end of life. Since 2003 the distinction has recognised cancer centres that achieve a high standard of integration of medical oncology and palliative care.5 The designation is valid for three years and in 2016 some 74 centres are due to re-accredit, of which seven joined the programme in 2003.
The survey presented today evaluated the characteristics and level of integration of palliative care services at ESMO Designated Centres by asking their leaders a series of 78 questions. Responses were received from 152 out of 184 centres polled (83%), of which 105 (76%) were in Europe. More than 80% said the programme had increased their status as cancer centres.
Programmes reported that 70% of patients with advanced cancer had a palliative care consultation. This occurred in a median of 90 days before death for outpatients and 10 days before death for inpatients.
ESMO Designated Centres had a high level of infrastructure to deliver palliative care and provided these services to a large proportion of patients with advanced cancer. More than one-third of centres (36%) were tertiary care cancer centres and 22% were tertiary care general hospitals. The median number of beds was 550.
Nearly all of the centres (90%) had inpatient consultation teams, while 88% had outpatient palliative care clinics, 71% had dedicated acute care beds, and 50% offered community based palliative care. Interdisciplinary teams existed in 95% of centres and 65% had dually certified palliative oncologists who were both a cancer specialist and a palliative care specialist.
All ESMO Designated Centres had conducted palliative care research in the past three years, and pain was the most common topic. Concerning education, 39% offered palliative care fellowship programmes, 32% had mandatory palliative care rotations for medical oncology fellows, 52% had a didactic palliative care curriculum for oncology fellows, and 73% offered continuing medical education for oncologists.
These results show that the growing community of ESMO Designated Centres of Integrated Oncology and Palliative Care have a high level of integration.