Unmet palliative care needs among patients with life-limiting illnesses

Unmet palliative-care needs remain common despite the well documented and wider recognition of early and integrated palliative care. This review examines recent evidence on unmet palliative-care needs among adults with advanced, progressive or life-limiting illness, with particular attention to how these needs are conceptualised and addressed across life-limiting illnesses.

Recent work distinguishes the presence of a concern, access to services, and the sufficiency of the response in terms of unmet palliative-care needs. Patient-level studies continue to show multidimensional needs, with psychological, informational, relational, spiritual, functional, practical, and financial concerns often less visible than physical symptoms. Evidence from non-cancer illness and underserved populations is expanding, but differences in definitions, instruments, thresholds, timing, and reports preclude uncritical comparison. Rurality, poverty, food insecurity, stigma, fragmented care, and communication barriers shape who can disclose needs and obtain support. Implementation studies increasingly link assessment to action, although most demonstrate feasibility, referral, or service contact rather than resolution of the original patient-valued need.

Current evidence supports assessment that records concerns about palliative care needs, whether help is wanted, who owns the response, what action follows, and whether support was sufficient. Services should not expand screening without response capacity. Comparative and intervention research should use patient-defined outcomes and include populations currently excluded by language, cognition, geography, and digital access.