Defining 'transition points' in the illness course as standardised times to integrate palliative care.

Despite emerging evidence of the benefits of palliative care, and the apparent match of this form of care with patient preferences in the setting of advanced disease, there remains marked variability and many gaps in access to palliative care. A series of barriers to accessing services include appropriate timing of introduction of palliative care, who requires these services and how they should be delivered. In this editorial, we raise the concept of evidence-based illness transitions as a solution to some of these barriers. Drawing on literature detailing integration of palliative care, these transitions are described as standardised points reached in an illness course, objectively identified and which herald a time of greater need – for care, for symptom relief. These transition points may be based in health service use milestones. By linking a clinician prompt to a transition point, a 'flag' can be raised for the clinician to consider tasks of palliative care or indeed a palliative care referral. In this way, through identification and use of illness transitions, integration of high quality end of life care can become standardised across populations and benchmarks for care can be established. [ABSTRACT FROM AUTHOR]