Pallium India

Last updated

Pallium India
Founded2003
FounderDr. M. R. Rajagopal
TypeNon-governmental charitable trust
Location
Area served
India
Website palliumindia.org

Pallium India is a national registered charitable trust formed in 2003 aimed at providing quality palliative care and effective pain relief for patients in India. Dr. M. R. Rajagopal [1] [2] is the founder and chairman of Pallium India. The organization works with national and international organisations to improve the accessibility and affordability of pain relief drugs (opioids) and other low-cost medicines, to ensure the availability of palliative care services in India and to improve the quality of palliative care services provided by the healthcare and allied health care professionals. In February 2016, Pallium India was accredited by Social Justice Department of Government of Kerala.

Contents

Activities

Pallium India seeks to insure equitable access to effective pain relief and quality palliative care alongside disease–specific treatment through delivery of services, education, building capacities, policy, research, advocacy and information. [3] [4]

Pallium India concentrates its activities on areas inadequately addressed by existing organizations. Pallium India works with Central and State Governments of India for integrating palliative care into the healthcare system, [5] facilitating palliative care education and improving access to essential and affordable medicines like morphine and other opioids.

In 2017, Pallium India opened a library dedicated to palliative care. Books were donated by the Elisabeth Kübler-Ross Foundation and Dr. Odette Spruyt of Peter MacCallum Cancer Centre. [6] [7]

Pallium India runs home visit programs in and around Trivandrum, as well as inpatient and outpatient clinics in collaboration with different hospitals in Trivandrum. [8] Other services include bereavement support groups, Vocational Rehabilitation Program for patients and families and education of children whose parents are under treatment by Pallium India. [9] Services to poor patients are provided free of cost, expenses met by donations.

The Trivandrum Institute of Palliative Sciences (TIPS) is an organ of Pallium India, established in 2006. In 2012, TIPS was declared a World Health Organization Collaborating Centre (WHOCC) for Training and Policy on Access to Pain Relief. [10] [11] Education and research are major activities of TIPS. TIPS provides medical care (inpatient, out-patient and home care services), counselling care, rehabilitation and other supportive services.

The Bruce Davis Training Centre (BDTC), the training division of Pallium India, runs a number of programs and trainings throughout the year with a focus on general awareness among the public and the expertise and competency of healthcare and allied healthcare professionals. These include Certificate Course in Pain and Palliative Medicine (CCPPM) for doctors, in Palliative Nursing (CCPN) for nurses and in Palliative Care (CCPC) for allied healthcare professionals. There are also volunteer training programs conducted frequently.

Pallium India works with several hospitals and organizations to catalyse the development of palliative care centres across India and for introducing palliative care education to professionals. [12] [13] [14] [15]

Pallium India collaborates with the Department of Social Justice of Government of Kerala to improve the facilities for wheelchair-bound people in the state. This includes providing rehabilitation services and advocacy for their improved mobility, including creating pavements and buildings that are wheelchair-friendly. [16] Pallium India regularly organizes awareness programs for the public, get-together for patients, art and craft exhibition, food festival and cultural events to spread the message of palliative care. [17] [18] [19]

Pallium India works with Paediatric and Paediatric Neurology departments of S.A.T Hospital, Thiruvananthapuram to provide palliative care for children suffering from various illnesses. [20] Pallium India works out of its office at Thiruvananthapuram, Kerala, India.

Currently, Pallium India is advocating for a rational national legislation for end of life care, which allows natural death with dignity and in incurable diseases with access to palliative care, rather than intensive care. [21] [22]

Achievements

Pallium India played a major role in the steps leading to the declaration of a National Program on Palliative care by the Government of India in 2012 November [23] and the Amendment of Narcotic Drugs and Psychotropic Substances(NDPS) Act of India in 2014. [24] [25] [26] In 2008, Pallium India initiated and followed up a proposal that resulted in the declaration of a "Palliative Care Policy" by the Government of Kerala, making it the first Government in a developing country to have such a policy. [27]

In 2016, Pallium India was awarded the Cancer Aid Society Annual Award for Excellence and Leadership in Palliative Care for the South Asian Association for Regional Cooperation (SAARC) Countries. [28] In November 2017, Pallium India was awarded Sat Paul Mittal Award of appreciation, in Ludhiana. [29]

A group of palliative care experts under the leadership of Dr M R Rajagopal, collaborated to prepare the draft curriculum for M.D. Palliative Medicine, on behalf of Medical Council of India. [30] A curriculum that introduces palliative care to undergraduate medical and nursing education has been submitted to the Medical Council of India.

Pallium India has catalyzed the development of training centres offering quality education in palliative care in Trivandrum (TIPS), Hyderabad (MNJIO RCC), Jaipur (Bhagwan Mahaveer Cancer Hospital and Research Centre) and Ahmedabad (GCRI).

With financial support from international agencies, ten palliative care service centres were established in different states of India - Jharkhand, Tripura, Uttar Pradesh, Manipur, Mizoram, Bihar, Orissa, Gujarat, Meghalaya, Tamil Nadu and Lakshadweep. In collaboration with Australasian Palliative Link International (APLI), Pallium India developed a mentoring program called Project Hamrahi for budding palliative care organizations in India [31] [32] [33]

Working with national and international experts, Pallium India created the National Standards tool (Minimum Standards for Palliative Care Programs) to ensure quality palliative care. [34]

An advocacy tool initiated by Pallium India with two international partners, called 'the Morphine Manifesto', caught the attention of the international palliative care community so much that 63 international organizations signed up to be launch partners. [35] [36] [37] [38]

Related Research Articles

Palliative care is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Within the published literature, many definitions of palliative care exist. The World Health Organization (WHO) describes palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain, illnesses including other problems whether physical, psychosocial, and spiritual". In the past, palliative care was a disease specific approach, but today the WHO takes a broader patient-centered approach that suggests that the principles of palliative care should be applied as early as possible to any chronic and ultimately fatal illness. This shift was important because if a disease-oriented approach is followed, the needs and preferences of the patient are not fully met and aspects of care, such as pain, quality of life, and social support, as well as spiritual and emotional needs, fail to be addressed. Rather, a patient-centered model prioritizes relief of suffering and tailors care to increase the quality of life for terminally ill patients.

<span class="mw-page-title-main">Government Medical College, Kozhikode</span> Medical school in Kerala, India

Government Medical College, Kozhikode, also known as Calicut Medical College, is a public medical college in Kozhikode, in the Indian state of Kerala.

<span class="mw-page-title-main">Thanatology</span> Scientific study of death and its aspects

Thanatology is the scientific study of death and the losses brought about as a result. It investigates the mechanisms and forensic aspects of death, such as bodily changes that accompany death and the postmortem period, as well as wider psychological and social aspects related to death. It is primarily an interdisciplinary study offered as a course of study at numerous colleges and universities.

In medicine, specifically in end-of-life care, palliative sedation is the palliative practice of relieving distress in a terminally ill person in the last hours or days of a dying person's life, usually by means of a continuous intravenous or subcutaneous infusion of a sedative drug, or by means of a specialized catheter designed to provide comfortable and discreet administration of ongoing medications via the rectal route.

Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia or advanced heart disease than for injury. In popular use, it indicates a disease that will progress until death with near absolute certainty, regardless of treatment. A patient who has such an illness may be referred to as a terminal patient, terminally ill or simply as being terminal. There is no standardized life expectancy for a patient to be considered terminal, although it is generally months or less. Life expectancy for terminal patients is a rough estimate given by the physician based on previous data and does not always reflect true longevity. An illness which is lifelong but not fatal is a chronic condition.

Brompton cocktail, sometimes called Brompton mixture or Brompton's cocktail, was an elixir meant for use as a pain suppressant dosed for prophylaxis. Made from morphine or diacetylmorphine (heroin), cocaine, highly-pure ethyl alcohol, and sometimes with chlorpromazine (Thorazine) to counteract nausea, it was given to terminally-ill individuals to relieve pain and promote sociability near death. A common formulation included "a variable amount of morphine, 10 mg of cocaine, 2.5 mL of 98% ethyl alcohol, 5 mL of syrup BP and a variable amount of chloroform water." Brompton's cocktail was given most in the mid twentieth century. It is now considered obsolete.

The Institute of Palliative Medicine is an education, training and research centre for palliative care located in Kozhikode, India. The institute trains health care professionals in palliative care and related medical disciplines. Through its connection with Calicut Medical College and other clinics in the state of Kerala, the institute supports between 4,500 and 5,000 patients per week. This institute is an organ of Pain and Palliative Care Society, Medical College, Calicut, which was founded in 1993.

M. Krishnan Nair was an Indian oncologist. He was the founding director of the Regional Cancer Centre, Thiruvananthapuram, a director of the S.U.T. Institute of Oncology, and Trivandrum Cancer Center(TCC), part of SUT Royal Hospital in Thiruvananthapuram (Trivandrum) and a professor at the Amrita Institute of Medical Sciences & Research in Kochi. The Government of India awarded him the fourth highest civilian award of the Padma Shri in 2001 for his contributions in the cancer care field.

<span class="mw-page-title-main">Ira Byock</span> American physician and author

Ira Robert Byock is an American physician, author, and advocate for palliative care. He is founder and chief medical officer of the Providence St. Joseph Health Institute for Human Caring in Torrance, California, and holds appointments as active emeritus professor of medicine and professor of community health and family medicine at the Geisel School of Medicine at Dartmouth College. He was director of palliative medicine at Dartmouth–Hitchcock Medical Center, from 2003–14, and associate director for patient and family-centered care at the affiliated Norris-Cotton Cancer Center.

Opioid-induced hyperalgesia (OIH) or opioid-induced abnormal pain sensitivity, also called paradoxical hyperalgesia, is an uncommon condition of generalized pain caused by the long-term use of high dosages of opioids such as morphine, oxycodone, and methadone. OIH is not necessarily confined to the original affected site. This means that if the person was originally taking opioids due to lower back pain, when OIH appears, the person may experience pain in the entire body, instead of just in the lower back. Over time, individuals taking opioids can also develop an increasing sensitivity to noxious stimuli, even evolving a painful response to previously non-noxious stimuli (allodynia). This means that if the person originally felt pain from twisting or from sitting too long, the person might now additionally experience pain from a light touch or from raindrops falling on the skin.

End-of-life care (EOLC) is health care provided in the time leading up to a person's death. End-of-life care can be provided in the hours, days, or months before a person dies and encompasses care and support for a person's mental and emotional needs, physical comfort, spiritual needs, and practical tasks.

<span class="mw-page-title-main">American Academy of Hospice and Palliative Medicine</span>

The American Academy of Hospice and Palliative Medicine (AAHPM) is a professional organization for physicians specializing in Hospice and Palliative Medicine, headquartered in Chicago, Illinois. Membership is open to all health care providers committed to improving the care of patients with serious or life-threatening illnesses. AAHPM has more than 5,200 members; 82 percent are physicians, 12 percent are nurses or other health care providers and 6 percent are residents or students.

<span class="mw-page-title-main">Hospice</span> Organization that cares for the dying or the incurably ill

Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life by reducing pain and suffering. Hospice care provides an alternative to therapies focused on life-prolonging measures that may be arduous, likely to cause more symptoms, or are not aligned with a person's goals.

Robert Twycross is a retired British physician and writer. He was a pioneer of the hospice movement during the 1970s, when he helped palliative care gain recognition as an accepted field of modern medicine.

In 2006, hospice and palliative medicine was officially recognized by the American Board of Medical Specialties, and is co-sponsored by the American Boards of

Anne Merriman, MBE, MCommH, FRCPI, FRCP is a British doctor, known for her pioneering work and influential research into palliative care in developing countries in Africa. She has campaigned to make affordable oral morphine widely available.

<span class="mw-page-title-main">M. R. Rajagopal</span> Indian palliative care physician (born 1947)

M. R. Rajagopal is an Indian palliative care physician (anesthesiologist) and professor referred to as the 'father of palliative care in India' in honour of his significant contribution to the palliative care scene in India.

<span class="mw-page-title-main">Stephen Connor (psychologist)</span>

Stephen Robert Connor is an American licensed clinical health psychologist, researcher, author, executive and palliative care consultant. He is the executive director of the Worldwide Hospice Palliative Care Alliance (WHPCA), formerly called the Worldwide Palliative Care Alliance (WPCA). From 1998 to 2008 he served as Vice President of Research and Development at the National Hospice and Palliative Care Organization (NHPCO). He has promoted global initiatives for hospice and end-of-life care programs through the World Health Assembly. He has also addressed the UN General Assembly on the need for greater pain management in palliative care.

The Worldwide Hospice Palliative Care Alliance or WHPCA is an international non-governmental organization based in the United Kingdom. In official relations with the World Health Organization (WHO), the WHPCA works in conjunction with over 200 regional institutions and national partners for the global development of palliative care and advancement of pain relief. It advocates for changes in public policy on accessibility of pain relief in end-of-life care and integration of palliative care into national health agendas. In 2014 it released the Global Atlas of Palliative Care at the End of Life in a joint publication with the WHO.

Naheed Dosani is a palliative care physician based in Ontario, Canada, who founded and leads the Palliative Education and Care for the Homeless (PEACH) program. For his efforts in providing mobile healthcare to individuals with vulnerable housing or are homeless, Dosani has received a Meritorious Service Cross from the Governor General of Canada (2017), and a Canadian Medical Association Award for Young Leaders (2020).

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