Last updated: 25/01/2011

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WHO designates new collaborative centre within palliative care

The Institute of Palliative Medicine (IPM ) was in November designated as a WHOCollaboratingCenter(WHOCC) in Palliative Care. IPM is now the fifth WHOCC in Palliative Care in the World and the first among developing countries.

- "Getting designated as a WHO Collaborating Centre is a great honour. We also realise that this new status also means substantial responsibilities”, says Dr Suresh Kumar, director of the IPM centre which official title now is WHO Collaborating Centre for Community Participation in Palliative Care and Long Term Care.

Why is this designation so important for your centre and palliative care in general?
- “Most of the people in need of palliative care live and die in low and middle income countries. Unfortunately, palliative care and long term care services are least developed in most of these countries. Systematic efforts by a variety of agencies both within and outside these countries are required to make the dream of appropriate care for the incurably ill, bed ridden and dying patients in these countries a reality. This will also mean facilitating socially innovative programs in palliative care and long term care. Socially and culturally appropriate research projects, collaboration with the south and also between north and south are also the pre requisites for this”, explains Dr Suresh.

The new centre is located at the Kerala Medical College in India. It ‘s activity concerns patients with non-communicable diseases, cancer and HIV/AIDS and will mainly focus on the following areas:

- Contribute to the development of the WHO primary health care package( PHC) for non communicable diseases (NCDs) especially in the area of palliative care in low resource settings through development of guidelines, protocols and standards for home based care in palliative care and long term care.

- Provide technical assistance for the development of community-based palliative care programmes in at least three other states in India and at least two neighbouring countries

- Development of education and training courses and material for the above thematic areas for health care workers and leaders, particularly at the PHC and community levels that can be adapted to other similar settings within India and beyond

- Development of education and training programs for doctors and nurses in palliative care and long term care

- “The WHOCC for Community Participation in Palliative Care and Long Term Care looks forward to joining hands with like minded agencies to work together to make sure that people in need of care and support get it irrespective of the race and community they are born in or the place they live". Dr. Suresh can be contacted via e-mail (drsuresh.kumar@gmail.com) or visit the web cite www.instituteofpalliativemedicine.org.

Archive News:

Risør Research Seminar 2010

The 2010 Risør Research Seminar of the EAPC Research Network and the European Palliative Care Research Centre (PRC) took place in the picturesque Norwegian coastal town, Risør. The first meeting of the newly established PRC saw 34 experts in palliative care research from all over the globe attend to discuss future studies and research strategy.

Photo: Professor Neil McDonald, McGIll University lectures on cachexia at the Risør Research Seminar.

Stein Kaasa expertly chaired the meeting during which it was announced by Dean Stig Slørdahl that Geoff Hanks and Augusto Caraceni have been appointed as part-time professors at the Faculty of Medicine, Norwegian University of Technology and Science in Trondheim. A variety of current and future studies were discussed, encompassing three key areas of cancer; pain, cachexia and symptom assessment.

Cancer Pain: Lessons learned and future research agenda

The meeting opened with Pål Klepstad presenting findings and experiences from the EPOS study. This was followed by the DNA analysis by Tommaso Dragani, and future directions for genetics studies postulated by Frank Skorpen. Skorpen highlighted that fundamental to future work is phenotype classification and the importance of optimisation of analgesia, before patients were labelled as poor responders. Rather than providing answers, the EPOS study has posed questions and illustrated important areas in which future work should focus.

Upcoming Research Projects

Pain was a key theme of the event with several cancer pain studies being discussed. Barry Laird and Geoffrey Hanks presented pilot data on the study of a two versus three step approach of the WHO analgesic ladder. Valuable thoughts on study design were gleaned from those present and the study is planned to start in 2011. Upcoming studies on nasal fentanyl and spinal opioids were also presented by Morten Thronæs and Kari Bruheim respectively. Symptom assessment is fundamental to clinical practice, but also to research. Studies in this area were presented by Augusto Caraceni and Declan Walsh. Both highlighted the importance of such epidemiological studies but also the difficulties and challenges presented.

Florian Strasser presented the status of a new classification system for cachexia, and together with Tora Solheim he also presented the multimodal interventional trial for cachexia (MENAC) which was well received. Using all interventions which independently have been shown to be of use (exercise, anti-inflammatory, nutritional supplements) in a single study, would be of great interest and this opening of this study is eagerly anticipated.

Cachexia

The importance of cachexia was an area for research was reflected by the presentations and debate which followed. Terje Espevik discussed the importance of inflammation in the genesis of cachexia and Neil MacDonald discussed ethical issues. In particular Neil MacDonald challenged the current practice whereby those who are in an oncology trial are prohibited from participating in symptom control studies. He challenged the PRC to take on the mantle of this dilemma.

“Study I want to do now“

An interesting aspect of the seminar was the “Study I want to do now“ component. Per Sjøgren discussed a study on pregabalin in visceral pain, Staffan Lundstrøm presented methadone as an adjuvant analgesic whilst Mike Bennett highlighted a package of work “SONIC” in neuropathic pain. All were warmly received and investigators were grateful for the input provided.

All enjoyed the meeting which Stein Kaasa summarised as a key platform on which to build the PRC.

Archive News:

Open meeting about the EAPC RN / PRC in Glasgow

(13.07.2010) The EAPC Research Network and European Palliative Care Research Centre (PRC) were on the agenda for an open meeting on the first day of the 6th Research Congress of the EAPC in Glasgow. 200 persons were presented with status on ongoing and future research projects, chaired by Dr Franco de Conno and Professor Geoffrey Hanks.

By Lotte Rogg and Patrick Reurink

Professor Stein Kaasa, chair of the EAPC RN and director of the PRC opened the meeting with an insight into the current strategy of EAPC RN, a research network for all palliative care research, and the PRC which mainly has a biomedical focus on cancer palliative care.

Professor Pål Klepstad briefed about the EPOS – study (European Pharmacogenetic Opioid Study) and presented his 10 commandments for clinical trials. A catchy general study idea, keeping it simple, a good organisation around the study with professional sample handling, good collaborators, funding, the possibility to have add-on studies, using the “right” instruments and bringing in the experts when needed are the most important lessons learned. In addition, everyone should get some kind of benefit from participating.

Professor Dagny F. Haugen presented the status on 6th EU Framework funded project,

EPCRC, which is to be finalised at the end of 2010. In addition, Dr Augusto Caraceni presented status on the EAPC opioid guidelines.

Other projects presented:

The European Palliative Care Symptom Study, presented by Dr Augusto Caraceni.

Multimodal Exercise/Nutrition/Anti-inflammatory treatment for Cachexia, presented by Professor Kenneth Fearon.

A research programme on Nasal Fentanyl vs. opioids around the clock, presented by Professor Stein Kaasa.

A study challenging the WHO ladder, Step II vs. Step III, presented by Professor Marie Fallon.

A randomised controlled study investigating the efficacy of intrathecal local anaesthetics and opioids, presented by Professors Per Sjøgren and Pål Klepstad.

RCT comparing the analgesic efficacy of 4 therapeutic strategies based on 4 different major opioids in cancer patients with moderate / severe pain, presented by Dr Oscar Corli.

The UK – Netherlands – Belgium – International Sedation Study, presented by Jane Seymour.

For more information on the different studies, visit the websites of EAPC RN and PRC.

Archive News:

The 6th EAPC Research Congress 10-12 June

The 6th Research Congress of the EAPC was held in Glasgow and broke several records for the highest number of submitted abstracts (663) and the highest number of participants (1406) from 39 countries. In all it was a great success and this congress secured the EAPC Research Congress as the premier international research meeting for palliative care.

By Mike Bennett (chair of the organising committee)

We were delighted to welcome so many international speakers for the plenary sessions and the many themed sessions which spanned all research areas including symptom control, family carers and end of life care trajectories. As is normal for the research congress, the majority of the programme consisted of oral presentations of submitted abstract which is a great strength of the meeting and a big incentive for researchers to submit their work. We awarded 5 prizes for the best oral abstracts and Drs Klepstad, Teno, Kurita, Simon and Abernethy were indeed worthy winners. We also presented the prestigious Junior Investigator Award to Dr Joachim Cohen for his exceptional work on using epidemiological data to research place of death.

The programme reflected the broad range of research in palliative care and also focused attention on a number of large European research initiatives including several multicentre studies and the recently formed Palliative Care Research Centre (PRC) in Trondheim, Norway. The PRC is now the centre-piece of the EAPC Research Network and it will further stimulate ambitious clinical research projects across Europe over the next years. The 7th EAPC Research Congress is scheduled for May 2012 in Trondheim, Norway.

For more information and direct link to the Congress homepage, click here.

Archive News:

The UNBIASED study on palliative sedation in Europe is about to start

Several research teams in UK, Belgium and the Netherlands participate in an in depth study of the use of therapeutic sedation at the bedside in these three countries. Please read more under Research Projects.

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