When Things Happen - The Story of COVID-19, Palliative Care, and An NGO.

Several natural disasters and the appearance of the coronavirus disease 2019 (COVID-19) pandemic created stressful situations to many health-care workers in the Philippines. New health-related challenges surfaced, and health-care workers felt lost since many of the challenges were either directly or indirectly caused by the fast-spreading coronavirus infections and its variants. Further, the way people die also changed, causing confusion and influencing the Filipino grief and bereavement processes. In response to the need of the health-care workers, a nongovernmental organization (NGO) through its education portal created and offered free webinars, aimed to help health-care workers understand and make sense of what was happening, thus empowering them with knowledge on how to manage the challenges and provide better care to the patients and the community as well. This article relates the process of planning and implementing online webinars during the era of social distancing and COVID-19 pandemic.

Palliative Care in the Global Setting: ASCO Resource-Stratified Practice Guideline.

Purpose The purpose of this new resource-stratified guideline is to provide expert guidance to clinicians and policymakers on implementing palliative care of patients with cancer and their caregivers in resource-constrained settings and is intended to complement the Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update of 2016. Methods ASCO convened a multidisciplinary, multinational panel of experts in medical oncology, family medicine, radiation oncology, hematology/oncology, palliative and/or hospice care, pain and/or symptom management, patient advocacy, public health, and health economics. Guideline development involved a systematic literature review, a modified ADAPTE process, and a formal consensus-based process with the Expert Panel and additional experts (consensus ratings group). Results The systematic review included 48 full-text publications regarding palliative care in resource-constrained settings, along with cost-effectiveness analyses; the evidence for many clinical questions was limited. These provided indirect evidence to inform the formal consensus process, which resulted in agreement of ≥ 75% (by consensus ratings group including Expert Panel). Recommendations The recommendations help define the models of care, staffing requirements, and roles and training needs of team members in a variety of resource settings for palliative care. Recommendations also outline the standards for provision of psychosocial support, spiritual care, and opioid analgesics, which can be particularly challenging and often overlooked in resource-constrained settings. Additional information is available at www.asco.org/resource-stratified-guidelines . It is the view of ASCO that health care providers and health care system decision makers should be guided by the recommendations for the highest stratum of resources available. The guideline is intended to complement but not replace local guidelines.

Community-based hospice and palliative care services in southern Metro Manila and neighboring provinces in the Philippines: A cross-sectional survey

BACKGROUND: The rising Filipino population results in a proportionate increase in the aging population and its health care needs.OBJECTIVE: In order to determine the demographic characteristics and needs of palliative and hospice patients in southern Metro Manila and surrounding provinces seeking care in a non-institutionalized setting, a chart review of 399 patients from 2 community-based hospice and palliative care programs was undertaken.RESULTS: Results show that the usual demographic profile of a patient seeking hospice and palliative care in the community setting of southern Metro Manila and neighboring provinces is female, 51-60 years old, with a diagnosis of cancer, breast cancer being the most common. Majority had undergone prior chemotherapy or radiation therapy. Hypertension was the most common co-morbidity associated with the primary diagnosis, and pain was the most common symptom reported. The children were the primary caregivers of these patients at home, and written advance care directives were unavailable or initial consultation. The most common spiritual concern of patients was not the fear of death, but being a burden to their family members. Complementary services may be needed in order to help patients and their families cope with the terminal illness. These may include social work to help connect the family to other institutions that provide free medicines, counselling sessions both for the patient and family, respite care or providing a day off for the caregivers, and skills training for the primary care givers.