scholarly journals Analytical review of the demand and satisfaction of the population with inhome palliative care services for cancer patients provided by mobile teams in Almatу

2020 ◽  
Vol 56 (2) ◽  
pp. 4-8
Author(s):  
T. N. Ansatbaeva ◽  
D. R. Kaidarova ◽  
G. Zh. Kunirova ◽  
N. А. Izmagambetov
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Cancer Patients ◽  
Malignant Neoplasms ◽  
Middle Income ◽  
Middle Income Countries ◽  
Care Services ◽  
Palliative Care Services ◽  
Analytical Review

Relevance: Patients with advanced malignant neoplasms require constant monitoring and care. Mobile palliative care (PC) is one of the modern humanistic methods of supporting terminal cancer patients, as well as their relatives. The purpose of this study was to analyze the demand and satisfaction of the population with in-home PC services for cancer patients provided by mobile teams in Almaty. Results: According to WHO, the number of people who need PС services at the end of life is 20.4 million, of whom 94% are adults (69% are over 60 years, 25% are at the age of 15 to 59), and 6% are children. 34% of patients dying from cancer need PC services at the end of life. 80% of people in need of PC services live in lower-middle-income countries. At the end of 2018, the total number of palliative beds deployed in the Republic of Kazakhstan amounted to 415 (vs. 373 in 2017). Conclusion: Given the practical relevance and topicality, there is an urgent need to develop evidence-based recommendations for optimizing the provision of PC services, as well as improving the quality of life of cancer patients

scholarly journals Analytical review of the demand and satisfaction of the population with in-home palliative care services provided by mobile teams for cancer patients in Almaty

2020 ◽  
Vol 56 (2) ◽  
pp. 3-6
Author(s):  
T. N. ANSATBAEVA ◽  
D. R. KAIDAROVA ◽  
G. Zh. KUNIROVA ◽  
N. А. IZMAGAMBETOV
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Cancer Patients ◽  
Malignant Neoplasms ◽  
Middle Income ◽  
Middle Income Countries ◽  
Care Services ◽  
Palliative Care Services ◽  
Analytical Review ◽  
The Republic

Relevance: Patients with advanced malignant neoplasms require constant monitoring and care. Mobile palliative care (PC) is one of the modern humanistic methods of supporting terminal cancer patients, as well as their relatives. The purpose of this study was to analyze the demand and satisfaction of the population with in-home PC services for cancer patients provided by mobile teams. Results: According to WHO, the number of people who need PС services at the end of life is 20.4 million, of whom 94% are adults (69% are over 60 years, 25% are at the age of 15 to 59), and 6% are children. 34% of patients dying from cancer need PC services at the end of life. 80% of people in need of PC services live in lower-middle-income countries. At the end of 2018, the total number of palliative beds deployed in the Republic of Kazakhstan amounted to 415 (vs 373 in 2017). Conclusion: Given the practical relevance and topicality, there is an urgent need to develop evidence-based recommendations for optimizing the provision of PC services, as well as improving the quality of life of cancer patients.

Effectiveness of palliative care services: A population-based study of end-of-life care for cancer patients

2018 ◽  
Vol 32 (8) ◽  
pp. 1344-1352 ◽  
Author(s):  
Rossana De Palma ◽  
Daniela Fortuna ◽  
Sarah E Hegarty ◽  
Daniel Z Louis ◽  
Rita Maria Melotti ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Cancer Patients ◽  
Conditional Logistic Regression ◽  
Emergency Department Visits ◽  
Administrative Databases ◽  
Hospital Death ◽  
Care Services ◽  
Palliative Care Services ◽  
The Impact

Background: Multiple studies demonstrate substantial utilization of acute hospital care and, potentially excessive, intensive medical and surgical treatments at the end-of-life. Aim: To evaluate the relationship between the use of home and facility-based hospice palliative care for patients dying with cancer and service utilization at the end of life. Design: Retrospective, population-level study using administrative databases. The effect of palliative care was analyzed between coarsened exact matched cohorts and evaluated through a conditional logistic regression model. Setting/participants: The study was conducted on the cohort of 34,357 patients, resident in Emilia-Romagna Region, Italy, admitted to hospital with a diagnosis of metastatic or poor-prognosis cancer during the 6 months before death between January 2013 and December 2015. Results: Patients who received palliative care experienced significantly lower rates of all indicators of aggressive care such as hospital admission (odds ratio (OR) = 0.05, 95% confidence interval (CI): 0.04–0.06), emergency department visits (OR = 0.23, 95% CI: 0.21–0.25), intensive care unit stays (OR = 0.29, 95% CI: 0.26–0.32), major operating room procedures (OR = 0.22, 95% CI: 0.21–0.24), and lower in-hospital death (OR = 0.11, 95% CI: 0.10–0.11). This cohort had significantly higher rates of opiate prescriptions (OR = 1.27, 95% CI: 1.21–1.33) ( p < 0.01 for all comparisons). Conclusion: Use of palliative care at the end of life for cancer patients is associated with a reduction of the use of high-cost, intensive services. Future research is necessary to evaluate the impact of increasing use of palliative care services on other health outcomes. Administrative databases linked at the patient level are a useful data source for assessment of care at the end of life.

scholarly journals The Association Between Home Palliative Care Services and Quality of End-of-Life Care Indicators in the Province of Québec

2015 ◽  
Vol 50 (1) ◽  
pp. 48-58 ◽  
Author(s):  
Bruno Gagnon ◽  
Lyne Nadeau ◽  
Susan Scott ◽  
Serge Dumont ◽  
Neil MacDonald ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Care Services ◽  
Palliative Care Services

Interpreting in palliative care: A systematic review of the impact of interpreters on the delivery of palliative care services to cancer patients with limited English proficiency.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 123-123 ◽  
Author(s):  
Milagros Silva ◽  
Margaux Genoff ◽  
Alexandra Zaballa ◽  
Stacy Marie Stabler ◽  
Francesca Gany ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Quality Of Care ◽  
End Of Life ◽  
Limited English Proficiency ◽  
Goals Of Care ◽  
Care Services ◽  
Palliative Care Services ◽  
The Impact

123 Background: According to the 2011 U.S. Census 60% of people living in the U.S. speak a language other than English at home, and of these approximately 40% have limited English proficiency (LEP). Language barriers can affect the health outcomes of LEP patients and the use of trained interpreters can improve patient-physician communication. Since effective communication is the cornerstone of delivering adequate palliative care, a systematic review was conducted to determine the impact of interpreters on the delivery of palliative care services to LEP patients with cancer. Methods: We conducted a systematic review of the literature search in all available languages of 6 databases from 1966 and 2013. Studies evaluated interpreter interventions for LEP patients receiving palliative care services. Of 38 references, 11 articles were found by multiple reviewers to meet inclusion criteria. Data were collected on the study design, size, comparison groups, outcomes, and interpreter characteristics. Results: A total of 6 qualitative and 5 quantitative studies assessed the use of interpreters. All studies found that the quality of care provided to LEP patients receiving palliative services is affected by communication. Most studies showed that when no trained interpreters were used, LEP patients and families had inadequate understanding about their diagnosis or prognosis during goals of care conversations, and worse symptom management at end of life including pain and anxiety. Half of the studies concluded that trained interpreters are not utilized adequately and several suggested that pre-meetings between clinicians and interpreters are important to discuss topics and terminology to be used during goals of care conversations. Conclusions: Published studies show worse outcomes during end of life care and goals of care discussions when trained interpreters are not used. Moreover, trained interpreters are not being used appropriately in the field. More clinically relevant studies are needed to improve the quality of care provided to LEP patients and families receiving palliative services.

scholarly journals Oncology-Based Palliative Care Development: The Approach, Challenges, and Solutions From North-East Region of India, a Model for Low- and Middle-Income Countries

2021 ◽  
pp. 223-232
Author(s):  
Nandini Vallath ◽  
Rewati Raman Rahul ◽  
Tanma Mahanta ◽  
Dipankar Dakua ◽  
Pranjal Protim Gogoi ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Care ◽  
Healthcare Systems ◽  
The State ◽  
Middle Income ◽  
Middle Income Countries ◽  
Care Services ◽  
North East ◽  
East Region ◽  
Palliative Care Services

BACKGROUND Access to palliative care within healthcare systems of low- and middle-income countries (LMICs) has never been more pronounced than in current times. The Lancet Commission Report (2018) estimates that 80% of global serious health-related suffering (SHS), which demands access to palliative care for its relief, are in LMICs. Cancer is a major contributor to SHS and a rapidly growing burden in LMICs. Similar to many LMICs, cancer is a leading cause of death in India. The North-East Region (NER) of India has a high prevalence of cancer and paucity of services for cancer and palliative care. OBJECTIVES To describe the strategies used to initiate and strengthen palliative care services integrated with the comprehensive cancer care initiatives in the state of Assam in NER. METHODS After an initial assessment of the status of palliative care in the NER, a multipronged strategy was adopted that aligned with the WHO framework recommended for initiating palliative care services. A core team working with a government and private collaborative strategized and activated supportive policies, education, and training and improved access and availability to essential drugs, while implementing the components synchronously within the state. SIGNIFICANCE This project demonstrates an informed regional adaptation of the WHO model. It highlights the strengths of integrating palliative care within cancer care program right from its inception. It emphasizes the sustainability of services activated across public healthcare systems, as compared with the donor- or champion-driven initiatives. The outcome of this project underlines the relevance of this model for LMIC regions with similar health systems and sociocultural and economic contexts.

scholarly journals Community health workers in palliative care provision in low-income and middle-income countries: a systematic scoping review of the literature

2020 ◽  
Vol 5 (5) ◽  
pp. e002368 ◽  
Author(s):  
MacKenzie Clark MacRae ◽  
Owais Fazal ◽  
James O'Donovan
Keyword(s):  
Palliative Care ◽  
Scoping Review ◽  
Low Income ◽  
Health Workers ◽  
Care Provision ◽  
Review Of The Literature ◽  
Middle Income ◽  
Middle Income Countries ◽  
Care Services ◽  
Palliative Care Services

BackgroundCommunity health workers (CHWs) are currently deployed in improving access to palliative care in a limited number of low-income or middle-income countries (LMICs). This review therefore aimed to document evidence from LMICs regarding (1) where and how CHWs are currently deployed in palliative care delivery, (2) the methods used to train and support CHWs in this domain, (3) the evidence surrounding the costs attached with deploying CHWs in palliative care provision and (4) challenges and barriers to this approach.MethodsWe conducted a systematic scoping review of the literature, adhering to established guidelines. 11 major databases were searched for literature published between 1978 and 2019, as well as the grey literature.Findings13 original studies were included, all of which were conducted in sub-Saharan African countries (n=10) or in India (n=3). Ten described a role for CHWs in adult palliative care services, while three described paediatric services. Roles for CHWs include raising awareness and identifying individuals requiring palliative care in the community, therapeutic management for pain, holistic home-based care and visitation, and provision of psychological support and spiritual guidance. Reports on training context, duration and outcomes were variable. No studies conducted a formal cost analysis. Challenges to this approach include training design and sustainability; CHW recruitment, retention and support; and stigma surrounding palliative care.ConclusionDespite relatively limited existing evidence, CHWs have important roles in the delivery of palliative care services in LMIC settings. There is a need for a greater number of studies from different geographical contexts to further explore the effectiveness of this approach.

What is palliative care?

2020 ◽  
Vol 14 (1) ◽  
pp. 19-26
Author(s):  
Francis Odukwe ◽  
Francis Ezeh
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
World Health Organisation ◽  
World Health ◽  
Care Services ◽  
Care Specialist ◽  
The World ◽  
Palliative Care Services ◽  
Serious Injuries

In 1990, the World Health Organisation (WHO) recognised palliative care as a distinct specialty dedicated to relieving suffering and improving quality of life for patients with life-limiting illnesses or serious injuries. Fourteen years later, the WHO in its publication ‘ Global Atlas of Palliative Care at the End of Life’, projected that, ‘each year in the world, around 377 per 100,000 of the adult (over 15 years of age) population and 63 per 100,000 of the child population (under 15 years of age) will require “palliative care at the end of life’. This article will discuss what constitutes palliative care, the different elements of palliative care, the approaches to palliative care, specialist palliative care services, end of life care and where GPs fit into this area. We will also be sharing tips on providing palliative care as a GP and for GP trainees.

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