473P - Palliative care as a part of national cancer control plan in Uzbekistan (473P)

Date 18 November 2017
Event ESMO Asia 2017 Congress
Session Poster lunch
Topics Palliative Care
Supportive and Palliative Care
Presenter Yakhyo Ziyaev
Citation Annals of Oncology (2017) 28 (suppl_10): x144-x148. 10.1093/annonc/mdx673
Authors Y. Ziyaev1, M. Tillyashaykhov1, S. Abdujapparov1, D. Egamberdiev1, I. Ziyaeva2, Y. Ten1
  • 1Science, National Cancer Center of Uzbekistan, 100174 - Tashkent/UZ
  • 2Oncology, Andijan State Medical Institute, 170100 - andijan/UZ

Abstract

Background

Palliative care is an integrated part of cancer patient care. However, the situation in palliative care in Uzbekistan is very critical. Morphine consumption of 0.04 mg per capita is a direct indication of painful deaths in this country.

Methods

We have created a questionnaire which evaluates the general health condition and health status of the patients. Simultaneously, we have created a questionnaire for doctors to evaluate the status of their knowledge in palliative care. 500 patients from cancer centers and in different stage of disease and 82 oncologists were surveyed. The survey for patients included physical pain status, psychological condition of the patient and self-evaluation of quality of life. Survey for doctors included evaluation of patients’ pain status, patients’ mood and knowledge of pain control.

Results

Patients were in pain through the whole course of disease. Patients in late stages had suffered from pain more than patients in early stages. Physical pain after surgery noted in all patients the mean pain status was 5.7. Mostly, NSAIDs in combination with H1 blockers were used to cope with pain, paracetamol was used only in one patient. Narcotic analgetics (nalbuphine, tramadol, promedole morphine) were used mostly during surgery, rarely in patients with IV stage of disease and in post-operative period. Most of the patients noted emotional fatigue and depression. However, predominant number of patients did not know their diagnosis and possible prognosis. More than half of the doctors (47-57.3%) knew the principles of step by step analgesia. But only a few (2-2.43%) used it in their day to day practice. The reasons for opiophobia were an unwillingness to fill in different forms as well as utilization of empty ampulas, fear of dependency and incorrect evaluation of patients’ pain status.

Conclusions

Palliative care situation in oncology in Uzbekistan is critical. Therefore, creating 15 departments of palliative care and 4 hospices throughout the country are implemented in NCCP. All above mentioned institutions will have mobile palliative care units. Protocols of palliative care and adequate pain control, simplifying the drug administration as well as development of education are being worked on now.

Clinical trial identification

N/A

Legal entity responsible for the study

National Cancer Center of Uzbekistan

Funding

Ministry of Health of Uzbekistan, National Cancer Center of Uzbekistan

Disclosure

All authors have declared no conflicts of interest.