Neuro-Oncology Palliative Care Survey of Physicians in Sub-Saharan Africa.

Journal: Journal of pain and symptom management

Volume: 62

Issue: 5

Year of Publication: 2021

Affiliated Institutions:  Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA. Sam Houston State University, Huntsville, TX, USA. Baylor Scott & White Medical Center, Temple, TX, USA. Baylor Scott & White Health, Waco, TX, USA. Hygeia Hospital, Athens, Greece. Baylor University, Waco, TX, USA. Baylor Scott & White Health, Dallas, TX, USA. Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA. Electronic address: Ekokobe.Fonkem@dignityhealth.org.

Abstract summary 

Early access to palliative care is a critical component of treating patients with advanced cancer, particularly for glioblastoma patients who have low rates of survival despite optimal therapies. Additionally, there are unique considerations for primary brain tumor patients given the need for management of headaches, seizures, and focal neurological deficits.We hoped to determine Sub-Saharan African physicians' level of understanding and skill in providing palliative care, types of palliative care therapies provided, role of cultural beliefs, availability of resources, and challenges faced.We conducted a survey of 109 physicians in Sub-Saharan Africa who treat brain tumor patients.Among the participants, 48% felt comfortable in providing palliative care consultations, 52% believed that palliative care is only appropriate when there is irreversible deterioration, 62% expressed having access to palliative care, 49% do not have access to liquid opioid agents, 50% stated that cultural beliefs held by the patient or family prevented them from receiving palliative care, and 23% stated that their own beliefs affected palliative care delivery. Older providers (age > 30) had a clearer understanding of palliative care (P = 0.004), were more comfortable providing consultation (P = 0.052), and were more likely to address mental health (P < 0.001).Palliative care delivery to glioblastoma patients in Sub-Saharan Africa is often delayed until late in the disease course. Barriers to adequate palliative care treatment identified in this survey study include lack of training, limited access to liquid opioid agents, and cultural beliefs.

Authors & Co-authors:  Tadipatri Ramya R Azadi Amir A Cowdrey Madison M Fongue Samuel Florian SF Smith Paul P Razis Evangelia E Boccia Maria M Ghouri Yumna Y Zozzaro-Smith Paula P Fonkem Ekokobe E

Study Outcome 

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Statistics
Citations : 
Authors :  10
Identifiers
Doi : 10.1016/j.jpainsymman.2021.04.011
SSN : 1873-6513
Study Population
Male,Female
Mesh Terms
Africa South of the Sahara
Other Terms
Africa;Palliative;brain cancer;neuro-oncology;sub-Saharan
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
United States