[Access to palliative care: which barriers for which patients?].

Palliative care was shown to be beneficial but too few patients have access to it. Barriers are a bad identification of patients, and a lack of knowledge as to their needs and the way palliative care can provide for them. There are communication difficulties. Patient and family representations were associated with a delay in referral to palliative care. Non cancer patients are referred even later as the evolution of the underlying disease is unpredictable. Expertise in palliative care was acquired with cancer patients and is not always suited to other patients' needs. Patients themselves are sometimes reluctant to turn to palliative care because it reminds them of cancer and an impending death. Doctors' education is warranted to improve access to and quality of palliative care.