Value-based medicine and palliative care: how do they converge?

Expert Rev Pharmacoecon Outcomes Res. 2019 Oct;19(5):509-515. doi: 10.1080/14737167.2019.1651645. Epub 2019 Aug 7.

Abstract

Introduction: Sick persons need doctors who understand their pathology, know how to treat their problem, and accompany them through their illness. This study aimed to synthesize the state of knowledge regarding the concept of value-based medicine (VBM) through an integrative literature review, and establish how VBM can be applied in palliative care. Areas covered: An integrative review was conducted with the keywords 'value-based medicine,' 'patient-centered care,' and 'medicina baseada em valor' (Portuguese for VBM) in PubMed and Virtual Health Library, identifying 17,189 articles in total. Of these, 10 articles met the eligibility criteria. VBM combines the highest level of technical-scientific data with patients' values. It is defined as the combination of evidence-based medicine, patient-centered care, and cost-effectiveness. Patients' values are a set of preferences, concerns, and expectations that contribute toward accommodating their needs in the treatment clinic. Expert opinion: Like VBM, palliative care focuses on patients' values and quality of life, respecting natural limits. The early development of a care plan with active participation of the patient in the face of life-threatening diseases should be encouraged and can bring peace and comfort in a person's final moments.

Keywords: Value-based medicine; cost efficiency analysis; decision making; palliative care; patient-centered care.

Publication types

  • Review

MeSH terms

  • Cost-Benefit Analysis
  • Decision Making
  • Evidence-Based Medicine / economics
  • Evidence-Based Medicine / methods*
  • Humans
  • Palliative Care / economics
  • Palliative Care / methods*
  • Patient-Centered Care / economics
  • Patient-Centered Care / methods
  • Quality of Life*