What is the preparedness and capacity of palliative care services in Middle-Eastern and North African countries to respond to COVID-19?: A rapid survey

Sabah Boufkhed; Richard Harding; Tezer Kutluk; Abdullatif Husseini; Nasim Pourghazian; Omar Shamieh

doi:10.1016/j.jpainsymman.2020.10.025

What is the preparedness and capacity of palliative care services in Middle-Eastern and North African countries to respond to COVID-19? A rapid survey

Sabah Boufkhed, Richard Harding, Tezer Kutluk, Abdullatif Husseini, Nasim Pourghazian, Omar Shamieh

Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation

Research output: Contribution to journal › Article › peer-review

23 Citations (Scopus)

Abstract

Context: Evidence from prior public health emergencies demonstrates palliative care's importance to manage symptoms, make advance care plans, and improve end-of-life outcomes. Objective: To evaluate the preparedness and capacity of palliative care services in the Middle-East and North Africa region to respond to the COVID-19 pandemic. Methods: A cross-sectional online survey was undertaken, with items addressing the WHO International Health Regulations. Nonprobabilistic sampling was used, and descriptive analyses were conducted. Results: Responses from 43 services in 12 countries were analyzed. Half of respondents were doctors (53%), and services were predominantly hospital based (84%). All but one services had modified at least one procedure to respond to COVID-19. Do Not Resuscitate policies were modified by a third (30%) and unavailable for a fifth (23%). While handwashing facilities at points of entry were available (98%), a third had concerns over accessing disinfectant products (37%), soap (35%), or running water (33%). The majority had capacity to use technology to provide remote care (86%) and contact lists of patients and staff (93%), though only two-fifths had relatives’ details (37%). Respondents reported high staff anxiety about becoming infected themselves (median score 8 on 1–10 scale), but only half of services had a stress management procedure (53%). Three-fifths had plans to support triaging COVID-19 patients (60%) and protocols to share (58%). Conclusion: Participating services have prepared to respond to COVID-19, but their capacity to respond may be limited by lack of staff support and resources. We propose recommendations to improve service preparedness and relieve unnecessary suffering.

Original language	English
Pages (from-to)	E13-E50
Journal	Journal of pain and symptom management
Volume	61
Issue number	2
Early online date	20 Nov 2020
DOIs	https://doi.org/10.1016/j.jpainsymman.2020.10.025
Publication status	Published - 1 Feb 2021

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.jpainsymman.2020.10.025

Cite this

@article{e4a5b465d40e4d12977a3e798ae90641,

title = "What is the preparedness and capacity of palliative care services in Middle-Eastern and North African countries to respond to COVID-19?: A rapid survey",

abstract = "Context: Evidence from prior public health emergencies demonstrates palliative care's importance to manage symptoms, make advance care plans, and improve end-of-life outcomes. Objective: To evaluate the preparedness and capacity of palliative care services in the Middle-East and North Africa region to respond to the COVID-19 pandemic. Methods: A cross-sectional online survey was undertaken, with items addressing the WHO International Health Regulations. Nonprobabilistic sampling was used, and descriptive analyses were conducted. Results: Responses from 43 services in 12 countries were analyzed. Half of respondents were doctors (53%), and services were predominantly hospital based (84%). All but one services had modified at least one procedure to respond to COVID-19. Do Not Resuscitate policies were modified by a third (30%) and unavailable for a fifth (23%). While handwashing facilities at points of entry were available (98%), a third had concerns over accessing disinfectant products (37%), soap (35%), or running water (33%). The majority had capacity to use technology to provide remote care (86%) and contact lists of patients and staff (93%), though only two-fifths had relatives{\textquoteright} details (37%). Respondents reported high staff anxiety about becoming infected themselves (median score 8 on 1–10 scale), but only half of services had a stress management procedure (53%). Three-fifths had plans to support triaging COVID-19 patients (60%) and protocols to share (58%). Conclusion: Participating services have prepared to respond to COVID-19, but their capacity to respond may be limited by lack of staff support and resources. We propose recommendations to improve service preparedness and relieve unnecessary suffering.",

author = "Sabah Boufkhed and Richard Harding and Tezer Kutluk and Abdullatif Husseini and Nasim Pourghazian and Omar Shamieh",

note = "Funding Information: The authors have no conflicts of interest to disclose. The authors would like to thank Shayma'a Turki, Ayman Issa and Dr. Nour Horanieh for their help in English-Arabic translations; Ghadeer Al-Arja and Waleed Alrjoob for their help in piloting the survey; and the World Health Organization's Eastern Mediterranean Region (WHO-EMRO) network for palliative care for their support and help in data collection. Sabah Boufkhed, Richard Harding (RH), Tezer Kutluk, and Omar Shamieh are funded through the UK Research and Innovation GCRF Research for Health in Conflict (R4HC-MENA); developing capability, partnerships and research in the Middle and Near East (MENA) ES/P010962/1. The overall vision for the R4HC-MENA partnership is to build sustainable research and policy capacity in the region to address major health challenges arising from conflict. R4HC-MENA activities aim to facilitate more effective translation of research into policy and deliver impact on both the research community and for patients and vulnerable populations. Principal and Co-Investigators: Adam Coutts, Brendan Burchell, Cengiz K?l??, Deborah Mukherji, Fouad M Fouad, Ghassan Abu Sittah, Hanna Kienzler, Kai Ruggeri, Kalipso Chalkidou, Matthew Moran, Omar Shamieh, Preeti Patel, Richard Harding, Richard Sullivan, Rita Giacaman, ?evkat Bahar ?zvar??, Simon Deakin, Tezer Kutluk, Wyn Bowen. RH is funded by the National Institute of Health Research (NIHR) Global Health Research Unit on Health System Strengthening in Sub-Saharan Africa, King's College London (GHRU 16/136/54) using UK aid from the UK Government to support global health research. The views expressed are those of the authors and not necessarily those of the UK Research and Innovation GCRF or the NIHR. The funding sources had no role in the design and content of this paper. Ethical approval was obtained from King's College London Research Ethics Office (reference LRS-19/20?19091). Publisher Copyright: {\textcopyright} 2020 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = feb,

day = "1",

doi = "10.1016/j.jpainsymman.2020.10.025",

language = "English",

volume = "61",

pages = "E13--E50",

journal = "Journal of pain and symptom management",

issn = "0885-3924",

publisher = "Elsevier",

number = "2",

}

TY - JOUR

T1 - What is the preparedness and capacity of palliative care services in Middle-Eastern and North African countries to respond to COVID-19?

T2 - A rapid survey

AU - Boufkhed, Sabah

AU - Harding, Richard

AU - Kutluk, Tezer

AU - Husseini, Abdullatif

AU - Pourghazian, Nasim

AU - Shamieh, Omar

N1 - Funding Information: The authors have no conflicts of interest to disclose. The authors would like to thank Shayma'a Turki, Ayman Issa and Dr. Nour Horanieh for their help in English-Arabic translations; Ghadeer Al-Arja and Waleed Alrjoob for their help in piloting the survey; and the World Health Organization's Eastern Mediterranean Region (WHO-EMRO) network for palliative care for their support and help in data collection. Sabah Boufkhed, Richard Harding (RH), Tezer Kutluk, and Omar Shamieh are funded through the UK Research and Innovation GCRF Research for Health in Conflict (R4HC-MENA); developing capability, partnerships and research in the Middle and Near East (MENA) ES/P010962/1. The overall vision for the R4HC-MENA partnership is to build sustainable research and policy capacity in the region to address major health challenges arising from conflict. R4HC-MENA activities aim to facilitate more effective translation of research into policy and deliver impact on both the research community and for patients and vulnerable populations. Principal and Co-Investigators: Adam Coutts, Brendan Burchell, Cengiz K?l??, Deborah Mukherji, Fouad M Fouad, Ghassan Abu Sittah, Hanna Kienzler, Kai Ruggeri, Kalipso Chalkidou, Matthew Moran, Omar Shamieh, Preeti Patel, Richard Harding, Richard Sullivan, Rita Giacaman, ?evkat Bahar ?zvar??, Simon Deakin, Tezer Kutluk, Wyn Bowen. RH is funded by the National Institute of Health Research (NIHR) Global Health Research Unit on Health System Strengthening in Sub-Saharan Africa, King's College London (GHRU 16/136/54) using UK aid from the UK Government to support global health research. The views expressed are those of the authors and not necessarily those of the UK Research and Innovation GCRF or the NIHR. The funding sources had no role in the design and content of this paper. Ethical approval was obtained from King's College London Research Ethics Office (reference LRS-19/20?19091). Publisher Copyright: © 2020 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/2/1

Y1 - 2021/2/1

N2 - Context: Evidence from prior public health emergencies demonstrates palliative care's importance to manage symptoms, make advance care plans, and improve end-of-life outcomes. Objective: To evaluate the preparedness and capacity of palliative care services in the Middle-East and North Africa region to respond to the COVID-19 pandemic. Methods: A cross-sectional online survey was undertaken, with items addressing the WHO International Health Regulations. Nonprobabilistic sampling was used, and descriptive analyses were conducted. Results: Responses from 43 services in 12 countries were analyzed. Half of respondents were doctors (53%), and services were predominantly hospital based (84%). All but one services had modified at least one procedure to respond to COVID-19. Do Not Resuscitate policies were modified by a third (30%) and unavailable for a fifth (23%). While handwashing facilities at points of entry were available (98%), a third had concerns over accessing disinfectant products (37%), soap (35%), or running water (33%). The majority had capacity to use technology to provide remote care (86%) and contact lists of patients and staff (93%), though only two-fifths had relatives’ details (37%). Respondents reported high staff anxiety about becoming infected themselves (median score 8 on 1–10 scale), but only half of services had a stress management procedure (53%). Three-fifths had plans to support triaging COVID-19 patients (60%) and protocols to share (58%). Conclusion: Participating services have prepared to respond to COVID-19, but their capacity to respond may be limited by lack of staff support and resources. We propose recommendations to improve service preparedness and relieve unnecessary suffering.

AB - Context: Evidence from prior public health emergencies demonstrates palliative care's importance to manage symptoms, make advance care plans, and improve end-of-life outcomes. Objective: To evaluate the preparedness and capacity of palliative care services in the Middle-East and North Africa region to respond to the COVID-19 pandemic. Methods: A cross-sectional online survey was undertaken, with items addressing the WHO International Health Regulations. Nonprobabilistic sampling was used, and descriptive analyses were conducted. Results: Responses from 43 services in 12 countries were analyzed. Half of respondents were doctors (53%), and services were predominantly hospital based (84%). All but one services had modified at least one procedure to respond to COVID-19. Do Not Resuscitate policies were modified by a third (30%) and unavailable for a fifth (23%). While handwashing facilities at points of entry were available (98%), a third had concerns over accessing disinfectant products (37%), soap (35%), or running water (33%). The majority had capacity to use technology to provide remote care (86%) and contact lists of patients and staff (93%), though only two-fifths had relatives’ details (37%). Respondents reported high staff anxiety about becoming infected themselves (median score 8 on 1–10 scale), but only half of services had a stress management procedure (53%). Three-fifths had plans to support triaging COVID-19 patients (60%) and protocols to share (58%). Conclusion: Participating services have prepared to respond to COVID-19, but their capacity to respond may be limited by lack of staff support and resources. We propose recommendations to improve service preparedness and relieve unnecessary suffering.

UR - http://www.scopus.com/inward/record.url?scp=85099773986&partnerID=8YFLogxK

U2 - 10.1016/j.jpainsymman.2020.10.025

DO - 10.1016/j.jpainsymman.2020.10.025

M3 - Article

C2 - 33227380

SN - 0885-3924

VL - 61

SP - E13-E50

JO - Journal of pain and symptom management

JF - Journal of pain and symptom management

IS - 2

ER -

What is the preparedness and capacity of palliative care services in Middle-Eastern and North African countries to respond to COVID-19? A rapid survey

Abstract

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this