Palliative care research--priorities and the way forward.

Palliative care is developed primarily outside academic institutions and with a primary focus upon service development. Initiatives to formalise the research structure were taken in Europe in 1996 by the European Association for Palliative Care (EAPC) through the establishment of the EAPC research network, and in 1998 in United Kingdom through the establishment of a palliative care research society. Most studies conducted in cancer palliative care up to now have been small and descriptive without the necessary quality to give input into evidence based medicine. The study population is described and defined differently between studies and there is no consensus on how to measure the most important outcomes, such as symptoms including pain, fatigue and depression in palliative care research. During the last decade, large research groups have been established in some countries--partly based upon national and international grants. In order to improve palliative care research nationally and internationally, these few groups of sufficient size and of sufficient output need to be given the responsibility and incentives to perform collaborative research nationally and internationally. It is necessary to train a sufficient number of clinician scientists within palliative care research and to give these scientists the possibility of permanent research posts in particular combined clinical and research posts after the research training period. National and international funding needs to continue and successful collaboratives need to receive predictable, sustainable funding. Since the majority of palliative care patients come from oncology, it is important to establish a close collaboration between these two disciplines.