Experts Agree: Palliative Care Needs Public Health Overhaul

Background: Palliative care is increasingly framed as a public health matter, with a range of new research approaches. However, there is currently no consensus on a research agenda for Public Health & Palliative Care. Aim: To set a preliminary consensus-based Public Health & Palliative Care research agenda for the coming decade. Design: A mixed-methods Delphi study using qualitative focus groups and quantitative digital surveys using a digital questionnaire. Items were ranked on Likert scales for appropriateness, relevance, feasibility and impact. Research Priority Scores were calculated as mean item scores across criteria and raters. Average Expert Agreement was calculated as mean proportion of raters who scored the mode result on each criterion per item. Setting/participants: A snowball sample starting from an initial list of 86 academic experts and people with complementary expertise from 16 countries. Results: Sixty-five invited experts responded in Round 1, fifty-one in Round 2. Results found 47 item priorities. Forty-four items had high to very high research priority (≥6/8). Average expert agreement was high (≥70%) for 37 of the 47 items. Priority domains included representation and inclusion (of older people and people in structurally vulnerable positions), access to palliative care and equity in health and wellbeing outcomes, critical knowledge, skills and social networks, and methodological development. Conclusions: Findings suggest that future priorities for Public Health & Palliative Care research lie with representation and inclusion, access to palliative care and equity in health and wellbeing outcomes, critical knowledge, skills, social networks and methodological development.