Palliative care research in Australia has had a rapid period of growth and development as a result of support of a National Palliative Care Program (2000 - 2010) funded by the Department of Health of Ageing. The Program was implemented following the Australian Health Ministers' Advisory Council endorsement of the first National Palliative Care Strategy in October 2000. In November 2010 the Australian Health Ministers' Conference endorsed the National Palliative Care Strategy 2010 (270kb pdf), and the Australian Government Department of Health continues to support palliative care initiatives through the National Palliative Care Projects funded under the National Palliative Care Program through to 2020. Research and project work has been undertaken within each of four major focus areas and resulted in a rich, diverse and productive series of investigations.
One focus area was research and quality improvement for palliative care services, and this included a joint initiative with the National Health and Medical Research Council (NHMRC) called the Palliative Care Research Program (2001 - 2010). A second focus area looked at increased access to palliative care medicines in the community which included funding for a clinical research collaborative, the Palliative Care Clinical Studies Collaborative (PaCCSC).
PaCCSC develops rigorous prospective multisite clinical trials so medications of importance to palliative care - if shown to be effective and safe - can be listed in the national Pharmaceutical Benefits Schedule for a palliative care indication.
During this period of research focus, a number of specialist research groups in Australia have emerged, usually as collaborations between academic institutions and clinicians. These have contributed significantly to the development of the palliative care field. Some groups are specifically focused on palliative care, whilst others cross disciplines and are close collaborators with palliative care researchers. These include:
- New South Wales
- Queensland
- CPCRE (Centre for Palliative Care Research and Education)
- PHC-RED (Primary Health Care Research Evaluation and Development Group)
- South Australia
- Victoria
- Western Australia
The capacity-building associated with the whole set of nationally funded palliative care programs including the National Palliative Care Strategy 2010 was evaluated in a 2016 Final Report. Over the last decade Australian palliative care clinicians have had greatly increased opportunities to become involved in rigorous clinical trials, well-designed qualitative studies and health services research. Practical learnings from this research program are being widely shared within the palliative care community, nationally and internationally.
Some examples of the new research in these areas include:
- Aspects of designing randomised controlled trials for palliative care settings [1-7,11]
- Issues related to ethics approval and adverse effect reporting in palliative care studies [8-9]
- World first guidelines for palliative care in residential aged care and companion guidelines for palliative care for older people living in the community
- Specific approaches to health economic assessment that capture what is important in palliative care [10]
- New methodologies to improve the quality and feasibility of palliative care research, for instance 'n of 1 trials' [11] or population estimates [12]
- New strategies to improve searching and retrieval of palliative care evidence [13-14]
- Issues in quality improvement activities [15-16] and
- Understanding the characteristics of carer populations and palliative care populations. [17-19]