The Indira Gandhi Medical College and Research Institute (IGMCRI) has launched a palliative care clinic to absorb a part of the burgeoning demand for pain relief in patients in an advanced stage of a variety of debilitating medical conditions.
The clinic, run by IGMCRI physicians who have undergone specialised training in palliative management at the Institute of Palliative Medicine (IPM) in Kozhikode, Kerala, will shortly begin offering outpatient services to cater to chronically ill patients referred from other institutions.
The IPM, a World Health Organisation (WHO)-collaborating centre for community participation in palliative and long-term care, and Sanjeevan, under the Sri Aurobindo Society here, are the IGMCRI’s partners for the palliative facility.
According to the plan, the clinic will be operated twice a week in the afternoons. While the sessions on Tuesdays will evaluate patients for the type of pain and determine an intervention plan, palliative care will administered on Fridays. “The primary goal is to improve the quality of life of terminally ill patients by providing pain relief and other forms of support.... We hope to set up a bedded unit for palliative care in the near future,” an IGMCRI doctor said.
The WHO estimates that each year, an estimated 56.8 million people, including 25.7 million in the last year of life, are in need of palliative care. The global atlas released in 2014 by the WHO and the World Palliative Care Alliance found that only 14% of those in need are receiving palliative care. And, of them, 78% of the unmet need was in low- or middle-income countries. According to one estimate, the demand-supply situation is acute in India where only about 2% of nearly 5.4 million patients in need of palliative care every year are able to access such services.
Among the immediate beneficiaries of the IGMCRI palliative clinic will be patients in advanced stages of cancer who are dependent on the overburdened oncology services at Jawaharlal Institute of Postgraduate Medical Education and Research (Jipmer).
It is also pointed out that palliative management is also indicated in other terminally advanced conditions, including HIV, where the available armamentarium has little benefit to offer. In essence, referrals to palliative clinic will be multi-speciality and multi-institutional.
‘Free of cost’
According to a doctor, the palliative armamentarium has widened in the recent years to go beyond opioids, inhibitors, epidurals and adjuvants to include specific interventions such as nerve block procedures, which constitute Step 4 of the WHO’s analgesic ladder. The biweekly clinic will offer these services free of cost to patients.
Meanwhile, holistic models of home and community-based care for the incurably ill and family care-givers that address a range of physical, psychological, social, emotional and spiritual needs have also evolved as alternatives to hospices. The tie-up with the IPM, which offers short-term courses on the speciality, aims at developing manpower with expertise in palliative medicine, doctors said.
The palliative clinic was formally launched by G. Sriramulu, Health Director, in the presence of Ramachandra V. Bhat, IGMCRI Dean; C. Udayashankar, IGMCRI Director; Joseph Rajesh, Medical Superintendent, Suresh Kumar, IPM Director; Kavita Vasudevan, Head of Community Medicine and Pratheeba, Head of Anaesthesiology.
Meanwhile, in connection with the launch of the clinic, the IGMCRI conducted a workshop on Addressing Pain in Palliative Care.
