Smriti Rana

Pallium India

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M. R. Rajagopal

Pallium India

Mark Stoltenberg

Massachusetts General Hospital

PalliCovidKerala Study Group

Amrita Institute of Medical Sciences and Research Centre

M. L. Dunne

Stanford University

Anu Savio Thelly

Mahatma Gandhi Medical College and Research Institute

James D. Harrison

University of California, San Francisco

Enrique Soto‐Pérez‐de‐Celis

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

Pascal Birindabagabo

World Health Organization - Pakistan

Mhoira Leng

General Hospital Ernakulam

Bishnu Dutta Paudel

KIST Medical College

Cooperative Institutions

Pallium India

Amrita Institute of Medical Sciences and Research Centre

General Hospital Ernakulam

Amrita Vishwa Vidyapeetham

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

Maulana Azad Medical College

University of the Witwatersrand

Malankara Orthodox Syrian Church Medical College Hospital

Harvard University

University of California, San Francisco

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Decolonization of pain relief policies in the Global South: a call for action

Supportive Care in Cancer (2025)

Parth Sharma Smriti Rana Preeti Chauhan T. R. DEVI Enrique Soto‐Pérez‐de‐Celis

Pain medicine

Call to action

10.1007/s00520-025-09217-y

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Citations (0)

31 Effectiveness of a palliative care resource toolkit for COVID 19 for low and middle income countries (LMICs) on health care workers knowledge and confidence levels

Poster presentations (2021)

Sunitha Daniel Chitra Venkateswaran Rajashree K Chittazhathu Smriti Rana Mhoira Leng

Background

Integrated palliative care (PC) has an important role in supporting those affected by the global COVID 19 pandemic. Communication and goals of care, symptom control and holistic support is needed particularly for patients and families living with multi-morbidity and populations in isolation and lockdown. Equipping health care workers (HCW) with core PC competencies is essential and often lacking. Building on models of integrated PC and effective response to humanitarian emergencies in Kerala, we developed and disseminated a Palliative Care in COVID-19 Resource Toolkit for LMICs comprising an e-book, webinars and ECHO platform interactive sessions for HCW.

Objective

To evaluate the impact of the Resource Toolkit on the knowledge and confidence levels of HCWs.

Methods

Participants registered for training package completed a pre and post course questionnaire with eighty percent attendance along with giving narrative feedback. Data collected from June to September 2020.

Results

A total of 388 participants from 8 countries including 24 Indian states; 27% male; median age 33 (20–65); 46% nurses & 27% doctors. There is statistically significant improvement in all factors assessed from pretest to post test. (p=0.000) ) Mean difference in knowledge & confidence in communication, goal setting, physical symptoms management, distress management and EOLC are as follows: 2.57 CI 95% ; (2.21 to 2.93), 2.34 CI 95%; (1.99 to 2.68), 2.72 CI 95%; (2.36 to 3.07), 2.55 CI 95%; (2.20 to 2.90), 2.42 CI 95%; (2.05 to 2.79), 2.38 CI 95%; (2.01 to 2.75), 2.88 CI 95%; (2.51 to 3.24),2.63 CI 95%; (2.27 to 2.99), 3.01 CI 95%; (2.65 to 3.38),2.76 CI 95% (2.39 to 3.13).

Conclusion

The Toolkit when combined with online interaction can support the integration of PC competencies in health care workers many of whom have no previous exposure to PC. Narrative feedback also supported the place of a safe forum to share. Further study is planned to assess the educational impact on practice.

Funding

Self-funded.

Attendance

Pandemic

Global Health

10.1136/spcare-2021-pcc.49

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Citations (1)

Global Palliative Care Education in the Time of COVID-19

Journal of Pain and Symptom Management (2020)

Marcia Glass Smriti Rana Rachel Coghlan Zachary I. Lerner James D. Harrison

Global Health

Pandemic

Humanitarian Crisis

10.1016/j.jpainsymman.2020.07.018

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Citations (19)

Epilogue: Reflections from Stakeholders of a Facilitated Community Partnership Developed to Provide Palliative Care to a Vulnerable Population in Kerala

Indian Journal of Palliative Care (2022)

Anu Savio Thelly Melanie Rose Smriti Rana

In mid-March 2020, the Kerala government implemented additional preventive measures to the steps already taken to reduce the transmission of COVID-19. Strategies were taken by a non-governmental palliative care organisation (Pallium India) with Coastal Students Cultural Forum - a coastal area-based collective of young educated people in the coastal region to address the medical needs of people living in this community. The facilitated partnership lasted 6 months (July-December 2020) and addressed the palliative care needs of the community in the selected coastal regions during the first wave of the pandemic. Volunteers sensitised by the NGO identified more than 209 patients. The current article highlights the reflective narratives of key players in this facilitated community partnership.The current article is dedicated to highlighting the reflective narratives of key players in this facilitate community partnership to the readers of this journal. The palliative care team's overall experience was collected from selected key participants to understand the program's impact, identify areas of improvement, and discuss possible solutions if there were any challenges. The contents below are their statements on the experience of the entire program.Palliative care delivery programmes must be configured to respond to local needs and customs, be community-based and integrated with local health and social care and have accessible referral pathways between and across services. They must also be responsive to changing individual and population needs and shifts in local and national health structures.

Local Community

10.25259/ijpc_81_2022

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Serious health-related suffering and palliative care in South Asian countries

Current Opinion in Supportive and Palliative Care (2021)

Ashwin R. Nambiar Smriti Rana M. R. Rajagopal

Purpose of review South Asia, with a population of 1.79 billion, has close to 9.9 million individuals experiencing serious health-related suffering (SHS). South Asia accounts for 10.23% of the world's cancer incidence. The prevalence of cancer mortality in the region is 68.44%, significantly higher than the world average of 59.74%. This poor outcome highlights the need to focus on SHS in the region. This review was undertaken to assess the current status of palliative care inequities in the region and to guide future action. Recent findings Using morphine-equivalent doses of opioid analgesics (excluding methadone) per cancer death as a proxy measure for access to palliative care, the International Narcotics Control Board data in 2020 show poor access to palliative care. Less than 4% of those in need are able to access palliative care in India, whereas in Afghanistan only 0.2% have access. Inappropriate end-of-life care (EOLC) and catastrophic out-of-pocket health expenditure compound the problem. Summary The solutions involve the introduction of national programs for palliative care, demonstration of culturally appropriate best practices as proof of concept, favourable legislation for medical opioid access, community participation, engagement of civil society to improve awareness, inclusion of palliative and adding EOLC to medical education and need-based research. Video abstract http://links.lww.com/COSPC/A30.

Proxy (statistics)

10.1097/spc.0000000000000565

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Citations (8)

End-of-life care needs decolonising

BMJ (2024)

Christian Ntizimira M. L. Dunne Smriti Rana Pascal Birindabagabo

Rich knowledge and practices of community and family based care for dying people in formerly colonised countries should inform a reimagination of palliative care globally, say Christian R Ntizimira and colleagues

End-of-Life Care

Terminal care

10.1136/bmj.q2810

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