World Hospice and Palliative Care Day: Only 1% patients in Maharashtra have access to palliative care: Doctors

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Published on Oct 11, 2019 11:58 PM IST
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Mumbai Only 1% of the one million patients who suffer from life-limiting illnesses in the state and need palliative care have access to such services, claim medical experts. Ahead of World Hospice and Palliative Care Day on October 12, doctors said the lack of awareness among medicos and patients alike is one of the most important reasons behind the small percentage of people coming forward to seek palliative care.

Palliative care includes a variety of medical services for those suffering from serious illnesses, such as cancer, chronic infections like HIV, drug-resistant tuberculosis, renal and liver failure, etc, and helps improve their quality of life. “In Mumbai, which has better facilities than other districts, we still receive only a small percentage of patients who actually seek palliative care. There are several causes behind it, but most importantly it is lack of awareness among people. Even medicos don’t refer patients to palliative care units,” said Dr Sunil Dhiliwal, consultant pain and palliative medicine, Asian Cancer Institute and founder of Dr Dhiliwals Pain & Palliative Care.

Dr Monique Kamat, chief executive officer, Narotam Sekhsaria Foundation, said India is classified under high palliative care requirement region of the world (as per Global Atlas of Palliative Care). “Around 175-275 people per 1,00,000 need palliative care in India. With increasing trend of non-communicable diseases and longevity of treatment, the demand for palliative care is bound to increase.”

However, doctors said despite the growing need for it, India lags behind western countries in providing the service. “We have very few trained palliative care specialists,” said Dr Rajam Iyer, palliative care specialist and pulmonologist, Bhatia Hospital.

Experts said there is a misperception that palliative care is needed only by patients with cancer. It can be provided to patients of any age suffering from life-limiting illnesses. It is provided at the early stages of treatment to help facilitate symptom control. The care can be given at home, in a residential hospice, hospital or personal care home. Experts said three myths stop patients from opting for the service. “Patients think that once they opt for the care, the medical treatment gets over. They think if they start procuring the service, they would be sent back home. Thirdly, they think palliative care means alternative form of medication like Ayurveda or homeopathy. This is wrong,” said Dr Dhiliwal.

Tata Memorial Hospital, Parel, which has India’s oldest palliative care unit — established in 1996 — has provided the service to more than 20,000 patients in the past three years, with a 13% annual growth in the number of the patients. “Highest of the cases are counted in gastrointestinal cancers, followed by lung and head/neck cancer cases. We also tied up with the state to revive their 2013 palliative action plan to establish one such centre at all district hospitals,” said Dr Jayita Deodhar, professor, department of palliative medicine, Homi Bhabha National Institute, TMH.

Two-thirds of the palliative care initiatives in India are in Kerala. Dr Ponissery Jayarajan, consultant, department of palliative care, PD Hinduja Hospital, said, “Maharashtra should also develop its own modules as currently 1% of those needing palliative care get it. Kerala is the only state that declared a pain and palliative care policy facilitating the development of community-based home care initiatives.”

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