Extension for Community Healthcare Outcomes-Palliative Care in Africa Program: Improving Access to Quality Palliative Care
PURPOSE: There is limited access to quality palliative care (PC) for patients with advanced cancer in sub-Saharan Africa. Our aim was to describe the development of the Project Extension for Community Healthcare Outcomes-Palliative Care in Africa (ECHO-PACA) program and describe a preliminary evalua...
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2019-07-01
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doaj-20b381df9307433c8ae6bceb021f22cc2020-11-25T03:34:15ZengAmerican Society of Clinical OncologyJournal of Global Oncology2378-95062019-07-0151810.1200/JGO.19.001281Extension for Community Healthcare Outcomes-Palliative Care in Africa Program: Improving Access to Quality Palliative CareSriram Yennurajalingam0Charles E. Amos Jr1John Weru2Edwina Beryl V.N.D. Addo Opare-Lokko3Joseph Anthony Arthur4Kristy Nguyen5Olaitan Soyannwo6Runcie C.W. Chidebe7Janet L. Williams8Zhanni Lu9Ellen Baker10Sanjeev Arora11Eduardo Bruera12Suresh Reddy13University of Texas MD Anderson Cancer Center, Houston, TXUniversity of Texas MD Anderson Cancer Center, Houston, TXAga Khan University Hospital, Nairobi, KenyaKorle-Bu Teaching Hospital, Accra, GhanaUniversity of Texas MD Anderson Cancer Center, Houston, TXUniversity of Texas MD Anderson Cancer Center, Houston, TXUniversity College Hospital, Ibadan, NigeriaProject Pink Blue, Abuja, NigeriaUniversity of Texas MD Anderson Cancer Center, Houston, TXUniversity of Texas MD Anderson Cancer Center, Houston, TXUniversity of Texas MD Anderson Cancer Center, Houston, TXProject Pink Blue, Abuja, NigeriaUniversity of Texas MD Anderson Cancer Center, Houston, TXUniversity of Texas MD Anderson Cancer Center, Houston, TXPURPOSE: There is limited access to quality palliative care (PC) for patients with advanced cancer in sub-Saharan Africa. Our aim was to describe the development of the Project Extension for Community Healthcare Outcomes-Palliative Care in Africa (ECHO-PACA) program and describe a preliminary evaluation of attitudes and knowledge of participants regarding the ability of the program to deliver quality PC. METHODS: An interdisciplinary team at the MD Anderson Cancer Center, guided by experts in PC in sub-Saharan Africa, adapted a standardized curriculum based on PC needs in the region. Participants were then recruited, and monthly telementoring sessions were held for 16 months. The monthly telementoring sessions consisted of case presentations, discussions, and didactic lectures. Program participants came from 14 clinics and teaching hospitals in Ghana, Kenya, Nigeria, South Africa, and Zambia. Participants were surveyed at the beginning, midpoint, and end of the 16-month program to evaluate changes in attitudes and knowledge of PC. RESULTS: The median number of participants per session was 30. Thirty-three (83%) of 40 initial participants completed the feedback survey. Health care providers’ self-reported confidence in providing PC increased with participation in the Project ECHO-PACA clinic. There was significant improvement in the participants’ attitudes and knowledge, especially in titrating opioids for pain control (P = .042), appropriate use of non-opioid analgesics (P = .012), and identifying and addressing communication issues related to end-of-life care (P = .014). CONCLUSION: Project ECHO-PACA was a successful approach for disseminating knowledge about PC. The participants were adherent to ECHO PACA clinics and the completion of feedback surveys. Future studies should evaluate the impact of Project ECHO-PACA on changes in provider practice as well as patient outcomes.http://ascopubs.org/doi/10.1200/JGO.19.00128 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sriram Yennurajalingam Charles E. Amos Jr John Weru Edwina Beryl V.N.D. Addo Opare-Lokko Joseph Anthony Arthur Kristy Nguyen Olaitan Soyannwo Runcie C.W. Chidebe Janet L. Williams Zhanni Lu Ellen Baker Sanjeev Arora Eduardo Bruera Suresh Reddy |
spellingShingle |
Sriram Yennurajalingam Charles E. Amos Jr John Weru Edwina Beryl V.N.D. Addo Opare-Lokko Joseph Anthony Arthur Kristy Nguyen Olaitan Soyannwo Runcie C.W. Chidebe Janet L. Williams Zhanni Lu Ellen Baker Sanjeev Arora Eduardo Bruera Suresh Reddy Extension for Community Healthcare Outcomes-Palliative Care in Africa Program: Improving Access to Quality Palliative Care Journal of Global Oncology |
author_facet |
Sriram Yennurajalingam Charles E. Amos Jr John Weru Edwina Beryl V.N.D. Addo Opare-Lokko Joseph Anthony Arthur Kristy Nguyen Olaitan Soyannwo Runcie C.W. Chidebe Janet L. Williams Zhanni Lu Ellen Baker Sanjeev Arora Eduardo Bruera Suresh Reddy |
author_sort |
Sriram Yennurajalingam |
title |
Extension for Community Healthcare Outcomes-Palliative Care in Africa Program: Improving Access to Quality Palliative Care |
title_short |
Extension for Community Healthcare Outcomes-Palliative Care in Africa Program: Improving Access to Quality Palliative Care |
title_full |
Extension for Community Healthcare Outcomes-Palliative Care in Africa Program: Improving Access to Quality Palliative Care |
title_fullStr |
Extension for Community Healthcare Outcomes-Palliative Care in Africa Program: Improving Access to Quality Palliative Care |
title_full_unstemmed |
Extension for Community Healthcare Outcomes-Palliative Care in Africa Program: Improving Access to Quality Palliative Care |
title_sort |
extension for community healthcare outcomes-palliative care in africa program: improving access to quality palliative care |
publisher |
American Society of Clinical Oncology |
series |
Journal of Global Oncology |
issn |
2378-9506 |
publishDate |
2019-07-01 |
description |
PURPOSE: There is limited access to quality palliative care (PC) for patients with advanced cancer in sub-Saharan Africa. Our aim was to describe the development of the Project Extension for Community Healthcare Outcomes-Palliative Care in Africa (ECHO-PACA) program and describe a preliminary evaluation of attitudes and knowledge of participants regarding the ability of the program to deliver quality PC. METHODS: An interdisciplinary team at the MD Anderson Cancer Center, guided by experts in PC in sub-Saharan Africa, adapted a standardized curriculum based on PC needs in the region. Participants were then recruited, and monthly telementoring sessions were held for 16 months. The monthly telementoring sessions consisted of case presentations, discussions, and didactic lectures. Program participants came from 14 clinics and teaching hospitals in Ghana, Kenya, Nigeria, South Africa, and Zambia. Participants were surveyed at the beginning, midpoint, and end of the 16-month program to evaluate changes in attitudes and knowledge of PC. RESULTS: The median number of participants per session was 30. Thirty-three (83%) of 40 initial participants completed the feedback survey. Health care providers’ self-reported confidence in providing PC increased with participation in the Project ECHO-PACA clinic. There was significant improvement in the participants’ attitudes and knowledge, especially in titrating opioids for pain control (P = .042), appropriate use of non-opioid analgesics (P = .012), and identifying and addressing communication issues related to end-of-life care (P = .014). CONCLUSION: Project ECHO-PACA was a successful approach for disseminating knowledge about PC. The participants were adherent to ECHO PACA clinics and the completion of feedback surveys. Future studies should evaluate the impact of Project ECHO-PACA on changes in provider practice as well as patient outcomes. |
url |
http://ascopubs.org/doi/10.1200/JGO.19.00128 |
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