Palliative care is customized medical care for those with a chronic illness, type of cancer, or a painful medical condition that decreases their quality of life. Palliative care helps to relieve suffering and the symptoms associated with physical pain. It focuses on improving the quality of life for both patients and their families and is provided by specially trained medical staff to asses the patient's emotional well-being, comfort level, and pain tolerance. .
Eighty percent of patients who need palliative care services live in low to middle resource countries; but only 10% of these patients have access to these services.
Based on evidence from high resource countries, palliative care can improve patient outcomes such as pain control, quality of life, satisfaction with care and the ability to die in one’s own home. At a health system level, palliative care can reduce emergency room visits, hospitalizations and overall healthcare costs. Unfortunately, only limited formative research has been conducted on palliative care in low to middle income resource countries.
The World Health Organization recently recommended that research is needed to adapt and test existing palliative care models for use in low to middle resource countries. To fill the gap in the evidence, we will develop a tailored palliative care intervention that will utilize patient navigators to deliver palliative care in a low resource setting. The study will be conducted in one cancer center located in the outskirts of Kolkata, also known as Calcutta, in India.
We plan to carry out feasibility testing of the palliative care intervention protocol using a single arm trial design. We will need to examine the acceptability of utilizing community-based patient navigators to deliver palliative care services.
We will pilot test the intervention in the 24 South Parganas region served by the SGCCRI over a 3-month period. We will document intervention usefulness, feasibility and acceptability among administrative, clinical and patient/caregiver stakeholders. This process will ensure that our final intervention fits within existing cancer center infrastructure and meets the needs of diverse stakeholders. To conduct this work, we will triangulate information from stakeholder interviews, navigator training evaluations and stakeholder evaluation surveys. We will pilot outcome measures for use in a future study to examine intervention efficacy. Informed written consent will be obtained prior to study participation for all stakeholders who complete interviews/surveys and patients who participate in the intervention.
Through this project, we will develop an evidence-based palliative care intervention that is tailored to the needs and preferences of stakeholders in the region of Kolkata, India. Our initial findings from this study will guide two subsequent research phases:
1) to pilot test the intervention for feasibility, acceptability and initial signs of effect on patients (e.g. symptom control, quality of life) and the health system (e.g. healthcare utilization, cost), and
2) to carry out a large-scale randomized controlled trial of the intervention in the rural regions surrounding Kolkata, India.
The ultimate goal of this research is to develop an evidence-based palliative care navigation intervention that can be broadly disseminated for use across low to middle resource countries.
Qualitative work required to conduct informant interviews and develop palliative care intervention toolkit.
There are no research supplies needed for this project.
There are no indirect costs associated with this project.