Abstract
Context
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.
Objective
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.
Methods
We conducted a survey of 109 physicians in Sub-Saharan Africa who treat brain tumor
patients.
Results
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).
Conclusion
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.
Key Words
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References
- Extension for community healthcare outcomes-palliative care in Africa program: improving access to quality palliative care.J Glob Oncol. 2019; 5: 1-8
- Cancer in Sub-Saharan Africa. IARC Scientific Publication No. 167.IARC Publications, Lyon, France2018
- Palliative care in Africa: a global challenge.Ecancermedicalscience. 2014; 8: 493
- Glioblastoma: overview of disease and treatment.Clin J OncolNurs. 2016; 20: S2-S8
- Challenges to curing primary brain tumours.Nat Rev ClinOncol. 2019; 16: 509-520
- Patterns of palliative radiotherapy in Africa, part 1: bone and brain metastases.Int J Radiat Oncol Biol Phys. 2008; 70: 1195-1201
- Palliative care in patients who receive whole brain radiotherapy for brain metastases in Ahmadu Bello University Teaching Hospital, Zaria.Niger J Med. 2016; 25: 215-219
- Palliative external beam radiotherapy for advanced breast cancer patients with brain metastasis in the university college hospital Ibadan.Ann Afr Med. 2019; 18: 127-131
- Patterns of practice in palliative radiotherapy in Africa - case revisited.Clin Oncol (R Coll Radiol). 2014; 26: 333-343
Article info
Publication history
Published online: April 29, 2021
Accepted:
April 16,
2021
Identification
Copyright
© 2021 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
