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|Year : 2007 | Volume
| Issue : 1 | Page : 1-2
Palliative care research and the IJPC
Department of Psychiatry, Christian Medical College, Bagayam, Vellore, India
Department of Psychiatry, Christian Medical College, Bagayam, Vellore - 632 002
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Alexander J. Palliative care research and the IJPC. Indian J Palliat Care 2007;13:1-2
It is with pleasure that I bring yet another edition of IJPC to you. Despite this somewhat delayed endeavour, one will find between the covers a variety of articles dealing with palliative oncology, psychological issues, policy statements and, more refreshingly, personal narratives and prose.
In the last seven years, the editor has often been faced with the daunting task of maintaining a continuous output of good-quality original articles that originate from within the subcontinent and would, therefore, be most relevant for members within the society. I have often wondered what it might take to transform this timid trickle of contribution into a steady stream or even a generous flow. While acknowledging the heavy clinical and administrative responsibilities under which many palliative care physicians work and the paucity of resources dedicated to research, I would like to discuss the issues involved under the following headings:
- Status of palliative care research worldwide
- Academic research training
- Availability of resources and funding for research activities
- New initiatives in palliative care research and future directions
| » Status of Palliative Care Research Worldwide|| |
Most of the research in palliative medicine is of a descriptive nature. Clinical practice is often based upon clinical experience rather than upon research.  Although new approaches are needed and must be developed for the dying patient, these are limited by the current levels of appropriate palliative care research.
It may appear that the paucity of palliative care research initiatives in India is a reflection of research status elsewhere in the world. However, while other regions seem to have made an effort to develop research initiatives,  palliative care in India is yet to shake off the inertia.
| » Academic Research Training|| |
The foundation for any research enquiry is often laid in training for the specialty. In recent years, the IAPC has seen a proliferation of various courses in palliative care for individuals with varied backgrounds. While one might argue that research methodologies are already included in several undergraduate and postgraduate curricula from which the heterogeneous palliative care population draws, it is my conviction that research needs renewed focus as part of palliative care education due to methodological and ethical challenges that are prominent in and unique to palliative care research. The situation is not very different from other more resource-rich countries where reviews of palliative care systems have revealed that there are few research groups in palliative care reaching a critical size. Additionally, several countries do not have academic chairs in palliative care, with no clear trend of chairs emerging in general either. 
It has been proposed that educational interventions in palliative care have four functions: extending personal scholarship, generating knowledge, training for the individuals and contributing to the growth of specialty.  Although higher research degrees in palliative care appear distant in India, it is an objective that the members of IAPC must collectively strain towards.
| » Availability of Resources and Funding for Palliative Care Research|| |
Palliative care researchers world over struggle for funds to conduct good-quality research. Not infrequently in India, palliative care services are still considered a luxury in the face of scarce resources. One needs to establish through researched evidence the widespread need for palliative care services for more resources to be allocated. Paradoxically, while research appears to be hampered by the lack of funding, future funding is linked to an established track record of appropriate research work and publications.
Original research can be kept simple and at low budget without compromising on quality.
In addition, the IAPC and like-minded bodies in India should explore avenues to support academic and research ventures in palliative care.
| » New Initiatives in Palliative Care Research and Future Directions|| |
One cannot emphasize enough the importance of a written and documented history of an organization's experiences and growth, so that we do not repeat the same mistakes and can build from our past experiences. More importantly, improvement of any service, in this case palliative care services, is directly related to the level of appropriate research. The lack of this may suggest a stagnation in the quality of services being rendered and should, therefore, be a cause of concern for IAPC. While it is heartening to see this association taking the lead in laying down standards and policies for activities associated with palliative care in the Indian subcontinent, the time is ripe for this association to initiate steps to stimulate a climate that fosters increased research, introspection and evaluation of existing services and a promotion of possible innovations and newer strategies. Following the strategic analysis published in 2002 by the National Cancer Research Institute (NCRI) and the recommendations of the NCRI's Strategic Planning Group (SPG), actions to strengthen research into Supportive and Palliative Care (SuPaC) have been initiated in the UK. This could possibly serve as a reasonable model to adapt to India with suitable modifications to allow for differences.
No therapeutic activity should be prescribed unless supported by researched credibility. I hope the IAPC members will use this journal to share information with their colleagues to whom it may be most relevant.
| » References|| |
|1.||Kaasa S, De Conno F. Palliative care research. Eur J Cancer 2001;37:153-9. |
|2.||Hospice and Palliative Care IA. The declaration of Venice: Palliative care research in developing countries. J Pain Palliat Care Pharmacother 2007;21:31-3. [PUBMED] |
|3.||Kaasa S, Hjermstad MJ, Loge JH. Methodological and structural challenges in palliative care research: How have we fared in the last decades? Palliat Med 2006;20:727-34. [PUBMED] [FULLTEXT]|
|4.||Higginson I, Conner J. Postgraduate research training: The PhD and MD thesis. Palliat Med 1996;10:113-8. |
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