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

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
• palliative care
• patient-centered care
• cost efficiency analysis
• decision making

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Article Highlights

• The active participation of patients in the doctor-patient relationship and decision-making processes has increased and should be stimulated.

• There is no consensus or descriptor regarding value-based medicine.

• Value-based medicine is the practice of medicine involving interventions that consider the highest level of evidence-based data as well as patients’ values and resources.

• Palliative care focuses on patients’ quality of life.

• Each person’s values, wishes, and goals to be achieved within each pathology should be included in advanced care planning.

Additional information

Funding

This paper was not funded.