From The President’s Desk
As you must be aware, the WHO has initiated a process for revising its issued guidance documents on pain management.
As part of an update of the 2011 WHO document “Ensuring balance in national policies on controlled substances: Guidance for availability and accessibility of controlled medicines”, the Division of Medicines, Vaccines, and Health Products is seeking experts to support the development of WHO guidance on national policies for safe and equitable access to controlled medicines. More information here.
In order to ensure that the process of selection/recruitment of experts is comprehensive and transparent, WHO has issued an open call for proposals for support in the development of this policy guidance from both individuals and experts.
The link to the call for experts is: https://www.who.int/docs/default-source/pain-management-documents/call-for-experts-aug-28-for-publication.docx
The deadline for proposals is 21 September 2019.
If you wish to contact the WHO regarding the application process may be directed to Dilkushi Poovendran.
For the most recent reporting on withdrawal of the guidelines please see this article in The Guardian – US attack on WHO ‘hindering morphine drive in poor countries’.
There is a lesson to be learnt from the opioid crisis in USA and the ‘Principle of Balance’ must always be kept in mind but it should not happen at the cost of deterioration in the already pathetic access to pain relief in the developing countries. We hope that there will be sufficient representation to the WHO advocating the necessity to keep in mind the suffering and lack of access in developing nations while revising these guidelines.
With best wishes,
Dr. Sushma Bhatnagar.
News & Events
TNAI Workshop on Palliative Care for Nurses
Trained Nurses Association of India, at the headquarters, Delhi, conducted a workshop on Palliative Care for Nurses on 19th Sept’19.Dr. Sushma Bhatnagar, President, IAPC inaugurated the workshop. Faculty present were Dr. Saveena Raheja, Dr. (Prof.) Madhu Dayal, Sr. Hanife Mac Gamwell, Prof. (Dr.) A. T. Kora, Mr. K. V. Hamza, Mrs. Shveta Seth and Mrs. Neelima.
AIIMS to ensure dignified death for non-cancer patients too
Durgesh Nandan, New Delhi.
Of the 80 countries surveyed recently for quality of death, India ranked 67. The result didn’t come as a surprise though because the concept of end-of-life care (EOLC) that attempts to reduce the suffering of the terminally ill patients barely exists in the country. In a first, All India Institute of Medical Sciences (AIIMS) has decided to draft a policy to provide the same to its registered in-patients. A core committee has been formed by the hospital to facilitate a dignified dying process for patients who are at their end of life. This includes non-cancer patients like those suffering from severe irreversible brain damage or those in a persistent vegetative state.
“Often, families of patients suffering from the end stage diseases request us to stop treatment. They don’t want to see them going away in pain and with multiple tubes inserted in the body. Our EOLC policy will attempt to address these issues,” Dr Randeep Guleria, the director of AIIMS, told TOI. He said that several rounds of consultation with stakeholders like experts in palliative care and the lawyers have already been held for the purpose. Also, the pallative medicine division of the hospital is training nurses and doctors to identify terminal stage of illness where palliative care may be required. Care will be ensured at all levels – physical, emotional, social and spiritual. AIIMS is one of the few medical institutions in the country to have a full-fledged department for palliative care. But till now, its focus has been on providing EOLC to cancer patients.
Dr Sushma Bhatnagar, professor and head of the department, said that they are expanding the services to other departments also. In India, the doctors say, the physicians are reluctant to consider limitation of life support interventions when compared to the doctors abroad. Dr Bhatnagar said that a policy which is legally vetted to remove grey areas in the implementation of EOLC is needed.
Updates & Information
Excerpts from a case study conducted by IIM Ahmedabad with few doctors and attentands involved in mob attacks – Breaking Bad News
This study reveals, attendants keep on changing
- Speak to every new attentand;
- Answer their every concern, do not hesitate, they might turn into your trouble makers.
The most important issue in communication is NOT WHAT YOU TALK, IT IS HOW YOU TALK:
- Tell patient all the treatment options;
- Involve them in Decision Making;
- Tell them why you have chosen this option, which parameters you want to Monitor; and
- And what changes will make you change your management decision…conservative to surgery.
Studies showed, patients who are more familiar to doctors create less problems…
- Identify the patient attendant who can create problem;
- Develop rapport with them-Know their name;
- Communicate with them, address their concerns.
To the 20% critical patients out of the 100 patients, you must give sufficient time, however busy you may be.
Train your staff to behave well and ask some to be in constant touch with the sick patient and attendants. Earn Patient TRUST AND CONFIDENCE.
Update them with Patient condition regularly. Breaking bad news should be done by Senior most doctor…don’t face the mob, call few key attendants into separate room.
Have proper eye contact, use simple words. Always Wear Neat apron to look like a doctor. Understand their feelings.
Prolonged Survival With Palliative Care – It Is Possible, but Is It Necessary?
Ryan Nipp, MD; Areej El-Jawahri, MD; Jennifer Temel, MD
To read the full article please visit: https://jamanetwork.com/ Tata Memorial Hospital by Raghunadharao Digumarti on 09/20/2019
Triaging the terminally ill
The concept of triage in emergency medicine has been around for centuries, but now researchers have developed a new tool to help triage those patients needing palliative care.
Rehabilitation Program at ‘Mashitahnde’
An initiative by Vadakara district hospital palliative care department, Kerela, receive paper pens made by patients who register under palliative care. A counter without salesman for paper pens the program is known as ‘Mashithande’, where pens are placed in the box at the counter, buyers would pay Rs 10/- in the box and get a pen. Eco friendly and patient friendly, Dr. Ali, Superintendent, Dr .Shibin, Mr. Chandran, Secretary, District hospital, Vadakara inaugurated this program.
Bruce David Gold Medal Examination
This prestigious award is for young doctors in India for their excellence in Palliative Medicine. Participate and win! National level online screening test is open.
Register now! Visit www.instituteofpalliativemedicine.org/bdgm.php
Palliative Medicine at Kidwai Cancer Center
Anybody with MBBS degree and more are eligible to enroll for the fellowship in Palliative Medicine at Kidwai Cancer, under Rajiv Gandhi University.
It is a 1 year course, starts from Sept/Oct 2019 to Sept/Oct 2020. Onetime payment fee: 35,000/-, Stipend 30,000/- per month.
IAPC Certificate Course
Next batch of IAPC Certificate Course in Essentials of Palliative Care will be starting on 1st November, 2019. Candidates can register for the course till 15th October 2019.
For brochure and application form, please visit [dt_button size=”small” animation=”none” icon=”” icon_align=”left” color=”” link=”https://palliativecare.in/academics-2/” target_blank=”true”]here[/dt_button]
First national conference of IAP, Pain and Palliative Care Chapter PAINPALL 2019
2nd and 3rd Nov’19, Shimla.
For registration log on to: https://www.onlinesbi.com/sbicollect/collecthome.htm?corpID=957184
SAVE THE DATE: Cardiology Palliative Care Master Class2019, 16th and 17th November’19 at Manipal Hospital, Old Airport Road, Bangalore on 16th and 17th November’19.
Jointly organized by Manipal Hospital Bangalore, Karunashreya and KMC Manipal.
Course Directors: Dr. Jermy Johnson and Dr. Miriam Johnson.
Participants: Cardiologists and Palliative care providers.
Limited registrations of 60.
SAVE THE DATE: Respiratory Care Master Class 2019 on 7th and 8th December’19 at Medical Educational Department, Health Science Library Building, Manipal Academy of Higher Education.
Jointly organized by Cipla Foundation, Cipla Palliative Care Center, and KMC Manipal.
Course Directors: Dr. David Currow, Dr. Rajam Iyer and Dr. Sujith Rajan.
Participants: Pulmonologists and Palliative Care providers .
Limited registration of 60.
Early Notification for the Annual advanced Therapeutics Course at Karunashreya on 23rd and 24th November’19.
Expert Faculty National and International already committed. Interesting and varied topics. Details to follow.
IAPCON 2020, Guwahati
27th International Conference of Indian Association of Palliative Care (IAPCON 2020)
Conference Dates: February 14th to 16th, 2020.
Pre-conference Dates: February 13th, 2020.
- Palliative Care Education in India
- Universal Access to Palliative Care
- Paediatric Palliative Care Empowering compassionate communities
- Political will for prevention & relief of suffering at the end of life
- North East Palliative Care: New initiatives
- Institute Based Palliative Care
- Rehabilitation & Palliative Care
- Nursing Issues Empower to improve competency
- Pain Management Research in Palliative Care
- Role of Volunteers & Social workers Safe use of opioids
- Palliative Care in Non-Malignant Diseases
- Engaging Students in Palliative Care
- Entrust: Joining hands with contemporaries
- Care for Caregivers
- Palliative Care Debate: “Implementing Advance Directives in India”
- Palliative Care Quiz
- Best 3 Oral Presentations
- Best 3 Poster Presentations
Dr. Arun Deka
First Floor, Administrative Block,
State Cancer Institute, Gauhati Medical College,
Bhangagarh, Guwahati – 781032, Assam, India.
Official Conference Managers:
28-32. Ground Floor, Rectangle-I,
Distt. Centre Saket. New Delhi-110017
For donations to the IAPC and for further information write to email@example.com
Visit us at https://palliativecare.in/iapc-annual-conference-iapcon-2020/ and leave your comments and queries.