Barriers to the early integration of palliative care in pediatric oncology in 11 Eurasian countries

Background The early integration of palliative care significantly improves quality of life for children with cancer. However, cultural, structural, and socioeconomic barriers can delay the integration of palliative care into cancer care, particularly in low‐income and middle‐income countries. To dat...

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Bibliographic Details
Published in:Cancer 2020-11, Vol.126 (22), p.4984-4993
Main Authors: Ehrlich, Bella S., Movsisyan, Narine, Batmunkh, Tsetsegsaikhan, Kumirova, Ella, Borisevich, Marina V., Kirgizov, Kirill, Graetz, Dylan E., McNeil, Michael J., Yakimkova, Taisiya, Vinitsky, Anna, Ferrara, Gia, Li, Chen, Lu, Zhaohua, Kaye, Erica C., Baker, Justin N., Agulnik, Asya
Format: Article
Language:English
Subjects:
Cancer
Children
Eurasia
global health
Income
Integration
low‐income and middle‐income countries (LMICs)
Medical personnel
Oncology
Palliation
Palliative care
palliative care integration
pediatric oncology
pediatric palliative care
Pediatrics
physician perspectives
Physicians
Polls & surveys
Qualitative analysis
Quality of life
Statistical analysis
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Summary:Background The early integration of palliative care significantly improves quality of life for children with cancer. However, cultural, structural, and socioeconomic barriers can delay the integration of palliative care into cancer care, particularly in low‐income and middle‐income countries. To date, little is known regarding the timing of and barriers to palliative care integration in Eurasia. Methods The Assessing Doctors' Attitudes on Palliative Treatment (ADAPT) survey evaluates physician perceptions regarding palliative care integration into pediatric oncology in Eurasia. This evidence‐based survey was adapted to the regional context; iteratively reviewed by US and regional panelists; and piloted in English, Russian, and Mongolian. After distribution to physicians caring for children with cancer, statistical analysis was complemented by qualitative analysis of open‐ended responses. Results A total of 424 physician responses were received from 11 countries in the Eurasian region. Study findings demonstrated wide variability in access to palliative care experts across countries (18%‐96%), with the majority of providers (64%) reporting that the initial palliative care consultation typically occurs when curative options are no longer available. Providers desired an earlier initial palliative care consultation than what currently occurs in their setting (P 
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.33151