Navigating challenges in palliative care: A survey on ASCO guideline adherence among health care providers in low- and middle-income countries Journal Article


Authors: Bergerot, C. D.; Soto-Perez-de-Celis, E.; Thompson, C.; Patel, R.; Al-Mondhiry, J.; Zhang, T.; Dhawan, N.; Burbage, D.; McCollom, J.; Tsang, M.; Sedhom, R.; Rosa, W. E.
Article Title: Navigating challenges in palliative care: A survey on ASCO guideline adherence among health care providers in low- and middle-income countries
Abstract: PURPOSEIntegrating palliative care into oncology is essential, yet disparities in access and quality persist, particularly in low- and middle-income countries (LMICs). The ASCO guidelines advocate for early, routine, interdisciplinary palliative care for patients with advanced cancer. Barriers to implementing these recommendations include resource limitations, inadequate training, and cultural perceptions. Recognizing these challenges is essential for improving equitable access to palliative care worldwide.METHODSThis prospective survey assessed adherence to ASCO recommendations for palliative care integration among LMIC health care providers (HCPs). Participants were recruited via e-mail, social media, and a list of members involved in the ASCO Palliative Care Communities of Practice from February to May 2024. The survey included sections on sociodemographic information, self-perceived adherence to ASCO guidelines on a 5-point Likert scale, and open-ended questions on implementation barriers. Data were collected using Research Electronic Data Capture system. Participants were grouped by WHO regions. Descriptive statistics were used to summarize characteristics and adherence scores, and chi-square tests were used to evaluate regional differences. Thematic analysis identified key themes from open-ended responses.RESULTSOne hundred eighty HCPs participated; 62% was female, and 51.1% was age 35-44 years. Most were physicians (66%), and 50% lacked palliative care specialization. Adherence to ASCO guidelines varied, with early palliative care referrals ranging from 50% in the Americas region to 0% in the Western Pacific region. Key barriers included lack of policy support (25%), unmet educational needs (22%), and accessibility constraints (19%).CONCLUSIONAddressing identified barriers through evidence-based advocacy, comprehensive policy changes, training, and continuing education programs is essential for integrating palliative care into oncology services across LMICs, promoting health equity for patients with cancer.
Keywords: american society; integration; european region
Journal Title: JCO Global Oncology
Volume: 11
ISSN: 2687-8941
Publisher: American Society of Clinical Oncology  
Date Published: 2025-06-01
Start Page: e2400625
Language: English
ACCESSION: WOS:001493557300001
DOI: 10.1200/go-24-00625
PROVIDER: wos
PMCID: PMC12123599
PUBMED: 40403199
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: William E. Rosa -- Source: Wos
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  1. William   Rosa
    201 Rosa