Novel patient-centred approaches for survivorship, palliation and/or end-of-life care

Proposals should demonstrate, the effectiveness and cost-effectiveness of new, improved or specifically adapted pharmacological and/or non-pharmacological interventions to either relieve symptoms (e.g. pain) and suffering caused by life-threatening non-communicable diseases (including disabilities), or serious late and long-term side effects of disease treatments in patients and survivors, or symptoms that occur at the end of life. Randomised clinical trials or observational studies of new or improved patient and/or family centred[[Involving patients and their caregivers (families, volunteers, nurses and others), and taking their views and values into account in care decisions.]] interventions, targeting children[[According to WHO "" A child is a person 19 years or younger unless national law defines a person to be an adult at an earlier age "" (http://www.who.int/hiv/pub/guidelines/arv2013/intro/keyterms/en/).]] and/or adults, should be considered for this topic. Proposals should give a sound feasibility assessment justified by available publications or preliminary results.

Proposals should prove the feasibility of integrating the proposed interventions in current pain management, palliative and/or end-of-life and/or survivorship care regimes and healthcare systems across Europe while taking into account the complex human aspects which are necessarily managed by such regimes and systems.

The proposals should address sex, gender, age and socio-economic factors in health and any other factors (e.g. ethical, familial, cultural considerations, including personal beliefs and religious perspectives, etc.) that could affect health equity.

The Commission considers that proposals requesting a contribution from the EU of between EUR 3 and 4 million would allow this specific challenge to be addressed appropriately. Nonetheless, this does not preclude submission and selection of proposals requesting other amounts.

Health conditions linked to end-of-life issues, acute and chronic pain, life-threatening non-communicable diseases, late or long term side effects and consequences of diseases and their treatments impact quality of life and pose an immense societal and economic burden. Palliative[[According to WHO, palliative care is ""an approach that improves the quality of life of patients and their families facing the problem associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual"" (http://www.who.int/cancer/palliative/definition/en/).]] end-of-life and survivorship care benefits patients with malignant and non-malignant chronic health conditions, providing relief from their symptoms and improving their quality of life. From 38% to 74.0% of the affected population[[Morin et al. Estimating the need for palliative care at the population level: A cross-national study in 12 countries. Palliat Med. 2016]] is estimated to be in need of palliative care. While a variety of interventions are in use, these are often not adequately validated or adapted to the specific needs of patients affected with a specific chronic disease or with multimorbidities. Therefore a need exists to strengthen the evidence base for available effective interventions improving quality of life in the domains of palliative, end-of-life and survivorship care.

• Reduced symptom burden and suffering or improved well-being of patients in need of palliative, end-of-life or survivorship care and their formal and informal caregivers.
• Improved clinical guidelines and policy recommendations with respect to pain management, palliative, end-of-life or survivorship care of patients with life-threatening non-communicable diseases or afflicted by late and long term side-effects of treatments.
• Improved quality, effectiveness and cost-effectiveness of palliative, end-of-life or survivorship care services as well as access to care.
• Reduced economic and wider societal burden arising from increased numbers of patients in need of palliative, end-of-life or survivorship care.