Strategies for Implementing Palliative Care Services for Cancer Patients in Low- and Middle-Income Countries: A Systematic Review.

Abstract

Palliative care (PC) services are essential for cancer patients, particularly in low- and middle-income countries (LMICs), where cancer-related deaths are disproportionately high. Despite their significance, access to effective PC remains limited in many LMIC settings. This systematic review aims to identify strategies for implementing PC services for cancer patients in these regions, focusing on the challenges faced. A comprehensive search was conducted for peer-reviewed articles published between January 2004 and July 2024, utilizing the databases Web of Science, Scopus, PubMed, and Google Scholar. The Critical Appraisal Skills Program (CASP) assessment tool was employed to evaluate the quality of the studies following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for transparency. Out of approximately 966 818 articles retrieved, only 17 studies met the defined inclusion criteria. The findings highlighted effective strategies for delivering PC services in LMICs, including patient navigator-led programs, telemedicine, and home health care services. The review highlighted several interventions for PC services, including massage, Cancer and Living Meaningfully (CALM), and light therapies. However, it also identified significant challenges, such as the educational levels of caregivers, patient acceptance of PC services, logistical issues, medication side effects, and a preference for traditional healing practices. This systematic review highlights the critical need for effective PC services for cancer patients in LMICs, where cancer-related mortality rates remain alarmingly high. By synthesizing data from various studies, this analysis offers a comprehensive framework for developing successful palliative care initiatives in these regions. It emphasizes the importance of training caregivers of cancer patients to enhance their confidence in delivering palliative care services and counseling patients about the benefits of these services. Utilizing this information can help practitioners and policymakers improve palliative care services, ultimately enhancing the quality of life for cancer patients in LMICs.