Development of palliative care clinical practice guidelines and referral care pathways for primary care practitioners in Pakistan

Authors

Syeda Amrah Hashmi, Aga Khan UniversityFollow
Russell Seth Martins, Aga Khan UniversityFollow
Annum Ishtiaq, Aga Khan UniversityFollow
Nashia Ali Rizvi, Aga Khan UniversityFollow
Mohsin Ali Mustafa, Aga Khan UniversityFollow
Alina Pervez, Aga Khan UniversityFollow
Ayra Siddiqui, Aga Khan UniversityFollow
Syeda Fatima Shariq, Aga Khan UniversityFollow
Sarah Nadeem, Aga Khan UniversityFollow
Adil H. Haider, Aga Khan UniversityFollow
Atif Waqar, Aga Khan UniversityFollow

Document Type

Article

Department

Medicine; Haematology/Oncology; Medical College Pakistan; General Surgery

Abstract

Background: Despite a large burden of life-limitingillness, there exists a dearth of services of palliative care in Pakistan. International guidelines have questionable applicability in Pakistan due to the socioeconomic differences. We generated a protocol describing the process of developing comprehensive palliative care guidelines and palliative care referral pathways for primary care practitioners to adopt in Pakistan.
Methods: A GRADE-ADOLOPMENT approach with modification has been employed to create guidelines for a Pakistani context. The "National Comprehensive Cancer Network Guidelines Insights: Palliative Care, Version 2.2021" was used as the source guideline. Recommendations from the source guideline were reviewed by two local palliative care specialists to either "Adopt," "Adapt" or "Exclude". The finalized recommendations were incorporated into the local palliative care guideline. Clinical diagnosis and referral pathways were made from the finalized guideline. Any gaps in management found in the pathways were filled by taking existing recommendations from other credible guidelines.
Results: Twenty-seven recommendations were adopted without modification. No recommendations were deemed to be adapted and 15 were excluded. The referral care pathways created were reflective of the local guideline and included elements of initial assessment, preliminary management, reassessment, and referral. 6 additional recommendations were made.
Conclusion: The described clinical practice guidelines and primary care clinical referral pathways will aid to standardize palliative care provision in Pakistan. These can be used by other resource constrained settings to develop guidelines within their own local context.

Comments

Pagination are not provided by the author/publisher.

Publication (Name of Journal)

BMC Palliative Care

DOI

10.1186/s12904-024-01438-y

Recommended Citation

Hashmi, S. A., Martins, R. S., Ishtiaq, A., Rizvi, N. A., Mustafa, M. A., Pervez, A., Siddiqui, A., Shariq, S. F., Nadeem, S., Haider, A. H., Waqar, A. (2024). Development of palliative care clinical practice guidelines and referral care pathways for primary care practitioners in Pakistan. BMC Palliative Care, 23(1).
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_med_med/705