Barriers to Palliative Care Integration for Children With Cancer Across Asia Pacific

Area of Science:

• Pediatric Oncology
• Palliative Care
• Global Health

Background:

• Early integration of palliative care (PC) is vital for improving outcomes in pediatric cancer patients.
• Access to PC services for children with cancer in the Asia Pacific (AP) region is notably scarce.

Purpose of the Study:

• To explore the barriers hindering the provision of PC in childhood cancer care across the AP region.
• To identify factors contributing to the limited availability of PC services for pediatric cancer patients in AP.

Main Methods:

• A survey, translated into six languages, was administered to physicians caring for children with cancer across 18 AP countries.
• Data were analyzed using descriptive statistics, with secondary analyses examining associations between physician training, subspecialty, and reported barriers.
• The McNemar test and analysis of variance were used to compare ideal versus actual PC consultation timing and perceived barriers across different country income levels.

Main Results:

• 621 physicians participated, revealing a significant gap between the ideal (59%) and actual (18%) timing of PC consultations at diagnosis.
• Key barriers identified include limited physician knowledge (82%), lack of national health policy (79%), insufficient PC-trained clinicians (79%), inadequate home-based services (78%), and physician discomfort (78%).
• Physicians in lower-middle-income countries reported these barriers more significantly.

Conclusions:

• A notable discrepancy exists between the desired and current integration of PC in pediatric oncology across the AP region.
• Findings highlight the need for targeted capacity building, education, and advocacy to enhance PC provision.
• Improving PC delivery requires addressing systemic issues like policy, training, and physician comfort to ensure timely and high-quality care for children with cancer.