The top 10 priorities in palliative care research in France: final results of the AXEPRO study
18 affiliations
- 1Institute of Engineering Univ. Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble INP, TIMC-IMAG, Grenoble, 38000 France
- 2Palliative Care Department, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
- 3Nantes Université, Tours Université, CHU Nantes, CHU Tours, INSERM, Methods in Patients-centered Outcomes and Health Research, SPHERE, Nantes, F-44000 France
- 4Service Interdisciplinaire Douleur, Nantes Université, CHU de Nantes, Soins Palliatifs et de Support, Médecine intégrative, Nantes, F-44000 France
- 5Département Recherche, Enseignement, Formation (DREF), Maison Médicale Jeanne Garnier, Paris, France
- 6Palliative Care Department, Centre Hospitalo, Universitaire de Nice, Nice, France
- 7Palliative Care Department, Centre Hospitalo, Universitaire de Caen, Caen, France
- 8EA3738 - Centre pour l’Innovation en cancérologie de Lyon-UFR Faculté de Médecin Lyon-Sud-Université Claude Bernard Lyon 1, Lyon, France
- 9Palliative Care Department, Strasbourg Translational Medicine Federation, University Hospital of Strasbourg, CNRS UPR 3212, ITI NeuroStra, University of Strasbourg, Strasbourg, France
- 10Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- 11Freelance Information Specialist, Paris, France
- 12NHS, Edinburgh, Scotland
- 13Social Sciences, Pacte Research Unit, UMR 5194, Grenoble, France
- 14Chargée de coordination à la Cellule d’Animation Régionale de Soins Palliatifs de la région Auvergne Rhône Alpes - Groupement de Coopération Sanitaire des Hôpitaux Universitaires Rhône Alpes Auvergne, Lyon, France
- 15Department of Public Health, Hospital Champagne Sud, Troyes, France
- 16Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX USA
- 17Department of Cardiology, Centre Hospitalo-Universitaire de Besancon, Besancon, France
- 18SINERGIES, University Marie & Louis Pasteur, 19 rue Ambroise Paré, Besançon, 25000 France
Abstract
Background: Prioritizing research is essential to reduce waste, particularly in palliative care, a field with historically limited investment. To identify and rank the top 10 unanswered palliative care research questions in France according to patients, caregivers, healthcare professionals and volunteers, a three-step priority-setting study was conducted between January 23, 2022, and September 24, 2024, based on the “Palliative and End of Life Care Research Priorities Project.”
Methods: Step 1 identified unanswered questions through an online unstructured questionnaire available online for 6 months using Limesurvey®. A multidisciplinary steering committee comprising two board-certified palliative care physicians, two methodologists, three nurses, a sociologist, an anthropologist and one information specialist, deleted duplicates, modified questions using the PICO format, did a literature review for each question using four Database. Step 1 included patients, caregivers, healthcare professionals and volunteers with at least a 2-year palliative care experience, recruited via the national end-of-life research platform and the SFAP (National Society for Palliative Care). Step 2 consisted of a six-month first-round prioritization survey. Step 2 have the same inclusion criteria as phase 1. Recruitment was identical to phase 1 and via 10 teaching hospitals. Priorities were established by consensus using average rankings based on the Borda method. Step 3 used a nominal group to reach consensus on the top 10 priorities. Inclusion criteria and recruitment were identical to phase 1 and 2. Patients were recruited via Grenoble teaching hospital. Step 3 involved 17 participants (3 patients, 5 family caregivers, 4 healthcare professionals, 5 volunteers). Verbatim discussions were analyzed using triangulation to identify major and minor themes underlying prioritization decisions.
Results: In Step 1, 560 verbatim responses generated 482 research questions, of which 32 were already addressed in the literature. Step 2 analyzed 413 questionnaires, with euthanasia emerging as the top theme. In Step 3, the highest-ranked question focused on improving patient information and supporting informed consent at the end of life.
Conclusions: Improving patient information emerged as a central issue, relevant to patient care, societal decision-making, and efforts to enhance patient involvement in palliative care research. Clinical teams and researchers need to address the unanswered questions quickly.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12916-026-05139-6.
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BibTeX
@article{barbaret2026priorities,
title = {{The top 10 priorities in palliative care research in France: final results of the AXEPRO study}},
author = {Cécile Barbaret and Raphaëlle Habert Dantigny and Adrien Evin and Sophie Chrétien and Flora Tremellat and Sarah Mensi and Guillaume Economos and Laurent Calvel and Héloïse Rouze and Caroline Tête and Sébastien Moine and Martin Julier-Costes and Valérie Amouroux-Gorsse and Isabelle Lavault and Justine Bret and Jan Crushiel and Eduardo Bruera and Fiona Ecarnot and Stéphane Sanchez},
journal = {BMC Medicine},
year = {2026},
month = aug,
doi = {10.1186/s12916-026-05139-6},
url = {https://doi.org/10.1186/s12916-026-05139-6},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - The top 10 priorities in palliative care research in France: final results of the AXEPRO study
AU - Cécile Barbaret
AU - Raphaëlle Habert Dantigny
AU - Adrien Evin
AU - Sophie Chrétien
AU - Flora Tremellat
AU - Sarah Mensi
AU - Guillaume Economos
AU - Laurent Calvel
AU - Héloïse Rouze
AU - Caroline Tête
AU - Sébastien Moine
AU - Martin Julier-Costes
AU - Valérie Amouroux-Gorsse
AU - Isabelle Lavault
AU - Justine Bret
AU - Jan Crushiel
AU - Eduardo Bruera
AU - Fiona Ecarnot
AU - Stéphane Sanchez
PY - 2026
DA - 2026/08/10
JO - BMC Medicine
DO - 10.1186/s12916-026-05139-6
UR - https://doi.org/10.1186/s12916-026-05139-6
AB - Background: Prioritizing research is essential to reduce waste, particularly in palliative care, a field with historically limited investment. To identify and rank the top 10 unanswered palliative care research questions in France according to patients, caregivers, healthcare professionals and volunteers, a three-step priority-setting study was conducted between January 23, 2022, and September 24, 2024, based on the “Palliative and End of Life Care Research Priorities Project.” Methods: Step 1 identified unanswered questions through an online unstructured questionnaire available online for 6 months using Limesurvey®. A multidisciplinary steering committee comprising two board-certified palliative care physicians, two methodologists, three nurses, a sociologist, an anthropologist and one information specialist, deleted duplicates, modified questions using the PICO format, did a literature review for each question using four Database. Step 1 included patients, caregivers, healthcare professionals and volunteers with at least a 2-year palliative care experience, recruited via the national end-of-life research platform and the SFAP (National Society for Palliative Care). Step 2 consisted of a six-month first-round prioritization survey. Step 2 have the same inclusion criteria as phase 1. Recruitment was identical to phase 1 and via 10 teaching hospitals. Priorities were established by consensus using average rankings based on the Borda method. Step 3 used a nominal group to reach consensus on the top 10 priorities. Inclusion criteria and recruitment were identical to phase 1 and 2. Patients were recruited via Grenoble teaching hospital. Step 3 involved 17 participants (3 patients, 5 family caregivers, 4 healthcare professionals, 5 volunteers). Verbatim discussions were analyzed using triangulation to identify major and minor themes underlying prioritization decisions. Results: In Step 1, 560 verbatim responses generated 482 research questions, of which 32 were already addressed in the literature. Step 2 analyzed 413 questionnaires, with euthanasia emerging as the top theme. In Step 3, the highest-ranked question focused on improving patient information and supporting informed consent at the end of life. Conclusions: Improving patient information emerged as a central issue, relevant to patient care, societal decision-making, and efforts to enhance patient involvement in palliative care research. Clinical teams and researchers need to address the unanswered questions quickly. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12916-026-05139-6.
SN - 1741-7015
ER -