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Chetna Malhotra

Assistant Professor

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Chetna Malhotra is an Assistant Professor at Lien Centre for Palliative Care and the Signature Program in Health Services and Systems Research, Duke-NUS. She is a physician specializing in Community Medicine and Public Health. Her work focuses on conducting health services research in the area of palliative and end-of-life care for patients with advanced serious illnesses including those with advanced cancer, heart failure, renal failure and dementia, with the goal of improving delivery of palliative care services to these populations. Specific areas of interest in the context of end-of-life research include: (1) understanding and meeting care preferences of patients and their caregivers, for example through advance care planning, (2) medical decision making, (3) patient-physician communication and (4) end-of-life suffering. She has experience leading survey-research studies, cohort studies, trials and qualitative research, and has authored or co-authored more than 60 peer reviewed publications in medical literature.

She is currently leading several research projects:

(1) Panel Study investigating status of cognitively impaired elderly in Singapore (PISCES) – This study is funded by the Ministry of Health Health Services Research Grant. It is a multi-centre cohort study of caregivers of patients with advanced dementia to assess patients’ end-of-life care, health care utilization, cost, quality of life, decision making and suffering during the last year of life.

(2) Communication quality between physicians and cancer patients in Singapore: This study assesses the preferences for communication and perception of quality of communication among advanced cancer patients with their physicians.

(3) Impact of advance care planning on care for patients with advanced heart failure: A randomized controlled trial - This is a 2-arm randomized controlled trial to assess the effectiveness of advance care planning in meeting patient’s end of life care preferences

She is co-investigator on several projects (selected):

(1)  Costs and Medical Care of Patients with Advanced Serious Illness in Singapore (COMPASS) Study – This is a cohort study of 600 patients with advanced cancers to assess their health care utilization, cost, and quality of life during the last year of their life.

(2) Singapore cohort of patients with advanced heart failure (SCOPAH) - This is a cohort study of 250 patients with advanced heart failure to better understand the relationship between patient preferences, health care access, utilization, costs, and quality of life and to identify strategies to improve the end of life experience for these patients.

  1. Malhotra C, Meibo H, Malhotra R, Sim D, Jaufeerally FR, Bundoc FG, Finkelstein E. Instability in end-of-life care preference among heart failure patients: Secondary analysis of a randomized controlled trial in Singapore. Journal of General Internal Medicine 2020 Feb 26[Online ahead of print]
  2. Malhotra C, Sim D, Jaufeerally FR, Meibo H, Nadkarni N, Hwa CN, Wong G, Cheng TB, Fen LJ, Ya-Ting CC, Finkelstein E. Impact of advance care planning on end-of-life care for patients with heart failure: Results from a randomized controlled trial. Journal of Cardiac Failure. 2020 Jan 25 [Online ahead of print]
  3. Malhotra C, Harding R, Teo I, Ozdemir S, Koh GC, Neo P, Lee LH, Kanesvaran R, Finkelstein E. Financial difficulties are associated with greater total pain and suffering among patients with advanced cancer: Results from the COMPASS study. Supportive Care in Cancer. 2019 Dec 12[Online ahead of print]
  4. Malhotra C, Rajasekaran R, Kanesvaran R,  Yee A, Bundoc FG, Singh R, Tulsky JA, Pollak KI. Pilot trial of a combined oncologist-patient-caregiver communication intervention. Journal of Oncology Practice 2020; 16 (2), e190-e200.
  5. Malhotra C, Kanesvaran R, Kumarakulasinghe NB, Tan SH, Ling X, Tulsky JA, Pollak KI. Oncologist-patient-caregiver decision making discussions in the context of advanced cancer in an Asian setting. Health Expectations 2020; 23 (1): 220-228.
  6. Malhotra C, Kanesvaran R, Krishna L, Xiang L, Kumarakulasinghe NB, Tan SH, Tulsky JA, Pollak KI. Oncologists’ responses to patient and caregiver negative emotions and patient perception of quality of communication: results from a multi-ethnic Asian setting. Supportive Care in Cancer. 2018; 26: 957-965.
  7. Malhotra C, Ling X, Ozdemir S, Kanesvaran R, Chan N, Finkelstein E. A comparison of attitudes toward length and quality of life between community dwelling older adults and patients with advanced cancer. Psycho-Oncology 2016; 26(10): 1611-1617.
  8. Malhotra C, Do YK. Public Health expenditure and health system responsiveness for low-income individuals: results from 63 countries. Health Policy and Planning. 2017; 32 (3): 314-319
  9. Malhotra C, Assad MA, Kanesvaran R, Bilger M, Finkelstein EA. Comparison of preferences for end-of-life care among patients with advanced cancer and their caregivers: A discrete choice experiment. Palliative Medicine. 2015; 29(9): 842-850. 
  10. Malhotra C, Chan A, Do YK, Malhotra R, Goh C. Good end-of-life care: perspectives of middle-aged and older Singaporeans. J Pain Symptom Manage. 2012;44(2):252-63.