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Inequality in pain relief at home for terminal patients

A study published in BMC Medicine indicates a stark inequality in the provision for pain relief and end of life care at home to individuals with terminal illnesses during their final 3 months.

Researchers at the University of Leeds analysed data derived from responses to the National Bereavement Survey (VOICES) in England (2011-2015) which asked families or close relatives about the quality of care received by their loved one who had died.

The findings showed that only 10 per cent of patients who succumbed to a non-cancerous disease received palliative care at home compared with 66 per cent of patients with cancer. Individuals receiving palliative care at home had a 2.7 times higher likelihood of getting good pain relief compared to those who did not receive palliative care. Although the association between good pain relief and palliative care at home was irrespective of the type of disease, access to palliative care remained unequal.

The study also found that patients who had planned their place of death were twice as likely to have good pain relief compared with those without a plan. Only a quarter of terminally ill patients were found to have conveyed their preferred place of death, and patients with cancer had a 3 times higher likelihood of having recorded a preference compared with non-cancer patients.

Professor Mike Bennett, the lead author, said: "It’s already been established that the home is the place where pain is least well controlled, so our findings clearly illustrate the importance of access to end of life care."


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