WHO关于《将缓和医疗整合至初级卫生保健指南》要点介绍及对我国的启示

A WHO Guide on Integrating Palliative Care and Symptom Relief into Primary Health Care:Key Points and Implications for China

WHO从2014年开始相继发布缓和医疗相关实施指南,为缓和医疗的实施提供了重要证据。在医疗资源紧张、缓和医疗需求增多、专科缓和医疗人力资源缺乏的背景下,以社区为中心的缓和医疗服务是解决缓和医疗使用不足的一种有效模式。2018年,WHO服务提供安全司联合美国、英国等国家和地区的专家共同制定了《将缓和医疗整合至初级卫生保健指南》,这是第一部系统说明如何将缓和医疗和初级卫生保健相整合的实施指南。该指南共8个章节,本文结合第3章节介绍缓和医疗和初级卫生保健整合的科学性和现实意义,结合第4、5、6章介绍如何将缓和医疗整合至初级卫生保健,主要包括社区基本医疗资源配置问题、药品管理问题、工作人员核心能力要求及社区健康工作者的重要作用,并介绍指南中部分地区和国家成功整合的案例,结合国内相关政策和研究,提出针对性建议。通过对该指南的介绍,希望可以为我国缓和医疗发展及进一步整合社区医疗资源提供参考。

The WHO has released several palliative care guidelines since 2014,providing important evidence for the implementation of palliative care.In the situation of limited medical resources,increased demand for palliative care,and limited palliative care specialists,community-based palliative care may be an effective model to solve the underuse of palliative care.In 2018,the WHO Department of Service Delivery and Safety,in collaboration with experts from the United States,the United Kingdom and other countries and regions,developed the Integrating Palliative Care and Symptom Relief into Primary Health Care,which is the first guide on how to systematically integrate palliative care into primary health care.This guide consists of eight chapters.We explained the scientific and practical significance of integrating palliative care into primary health care based on Chapter 3,and discussed how to integrate palliative care into primary health care based on Chapters 4,5 and 6,mainly including the allocation of essential medical resources and drug management in the community,core palliative care competencies requirements for primary care providers,as well as the important role of community health workers.In addition,we introduced successful integration cases of some regions and countries in the guide,and put forward suggestions feasible for domestic implementation in accordance with relevant domestic policies and research.The introduction of this guide may provide help for the development of palliative care and further integration of community medical resources in China.