Principal Investigator:
Eric A. Finkelstein, Executive Director, Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Study Team:
Semra Özdemir, Chetna Malhotra, Irene Teo Eng Ai, Ssu Wynn Mon, Gayatri Palat, Ning Xiao Hong, Thushari Hapuarachchi, Sushma Bhatnagar, Anjum Khan Joad, Pham Nguyen Tuong, Rubayat Rahman, Lubna Mariam, Maria Fidelis
Manalo, Rudi Putranto
Background:
As with many countries around the world, countries in Asia have experienced a shift in causes of death from infectious to chronic diseases, resulting in a protracted dying process that the current healthcare
infrastructure, particularly in the low- and middle-income countries of the region, is struggling to address. Moreover, these countries do not have the adequate resources or infrastructure to provide the best available
treatments or systematic coverage of basic palliative care and home based services.
Objectives:
The study aims to fill the knowledge gap of understanding advanced cancer patients’ quality of life and treatment relative to their expectations in this region.
Design:
Between 2016 and 2018, we conduct a one-time survey of 200 advanced cancer patients in each participating hospital in Asia. The core research domains aim to assess quality of life, quality of care, awareness and
preferences for prognostic information, and involvement in treatment decision making. Additionally, patient’s use of complementary and alternative medicine, psychological distress, self-blame and social stigma are
assessed according to their relevance in the subject country.
We also conduct a structured interview with the site-PIs (proxy) of the institutions to assess the end of life and palliative care services/systems in place which helps in comparing the different types of institutions
involved within and across countries and investigate how institutional characteristics are associated with patient health outcomes. The study is funded by Lien Centre for Palliative Care with support from Asia Pacific
Hospice Palliative Care Network and the collaborating institutions. To the best of our knowledge, this is the first study which aims to provide a cross-country comparison of end-of-life care services for cancer patients
in middle and low-income countries in Asia.
Study sites:
The survey is conducted in collaboration with 12 investigators from institutions across Bangladesh, China, India, Indonesia, Sri Lanka, Myanmar, the Philippines, and Vietnam.
Implications:
The study primarily has implications for increasing the standard of palliative care in the low- and middle income countries in Asia. The findings from this study will be helpful for policy makers to identify the key
areas for improvement of end-of-life care within and across countries.
Publications:
Pham, N. T., Lee, J. J., Pham, N. H., Phan, T., Tran, K., Dang, H. B., Teo, I., Malhotra, C., Finkelstein, E. A., & Ozdemir, S. (2021). BMC palliative care, 20(1), 104. https://doi.org/10.1186/s12904-021-00803-5
Teo, I., Ozdemir, S., Malhotra, C., Yang, G. M., Ocampo, R. R., Bhatnagar, S., Hapuarachchi, T., Joad, A. K., Mariam, L., Palat, G., Rahman, R., Finkelstein, E. A., & APPROACH study group (2021). Journal of pain and symptom management, S0885-3924(21)00285-2. Advance online publication. https://doi.org/10.1016/j.jpainsymman.2021.04.005
Satija, A., Bhatnagar, S., Ozdemir, S., Finkelstein, E., Maholtra, C., Teo, I., & Yang, G. M. (2021). The American journal of hospice & palliative care, 10499091211042837. Advance online publication. https://doi.org/10.1177/10499091211042837
Malhotra C, Krishnan A, Yong JR, Teo I, Ozdemir S, Ning XH, Hapuarachchi T, Palat G, Bhatnagar S, Joad AK, Nguyen TM, Mon SW, Finkelstein EA. International Journal for Equity in Health.2020; 19(1):158.
Mon SW, Myint Z, Myint M, Win H, Zin T, Yang GM, Malhotra C, Teo I, Finkelstein EA, Ozdemir S. Asia-Pacific Journal of Clinical Oncology.2020. Published Online First. doi: 10.1111/ajco.13430
Ning X, Krishnan A, Li X, Liu Z, Li J, Dai X, Ozdemir S, Malhotra C, Finkelstein EA, Teo I. Journal of Supportive Care in Cancer.2020; 10.1007/s00520-020-05559-x.
Doble B, Lau E, Malhotra C, Ozdemir S, Teo I, Finkelstein EA, APPROACH study group. Journal of psychosomatic research.2020. Published Online First. doi: 10.1016/j.jpsychores.2020.110284
Mon SW, Ozdemir S, Zu WWM, Win H, Maw MM, Win KC, Thant KZ, Teo I, Krishnan A, Goh CR, Finkelstein EA, Malhotra C. Asia-Pacific Journal of Clinical Oncolgy.2020: 10.1111/ajco.13371.
Jacob J, Palat G, Verghese NR, Chandran P, Rapelli V, Kumari S, Malhotra C, Teo I, Finkelstein EA, Ozdemir S. BMC Palliative Care.2019;18(1):94.
Presentation/s
25 September 2020
Project Start Date:
January 2015
Contact Person:
Kat: ekaterina.utkina@duke-nus.edu.sg