Browsing by Author "Cleary, Jim"

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    Global Assessment of Palliative Care Need: Serious Health-Related Suffering Measurement Methodology
    (Elsevier, 2024) Kwete, Xiaoxiao J.; Bhadelia, Afsan; Arreola-Ornelas, Héctor; Mendez, Oscar; Rosa, William E.; Connor, Stephen; Downing, Julia; Jamison, Dean; Watkins, David; Calderon, Renzo; Cleary, Jim; Friedman, Joseph R.; De Lima, Liliana; Ntizimira, Christian; Pastrana, Tania; Pérez-Cruz, Pedro E.; Spence, Dingle; Rajagopal, M. R.; Vargas Enciso, Valentina; Krakauer, Eric L.; Radbruch, Lukas; Knaul, Felicia Marie; Medicine, School of Medicine
    Context: Inequities and gaps in palliative care access are a serious impediment to health systems especially in low- and middle-income countries and the accurate measurement of need across health conditions is a critical step to understanding and addressing the issue. Serious Health-related Suffering (SHS) is a novel methodology to measure the palliative care need and was originally developed by The Lancet Commission on Global Access to Palliative Care and Pain Relief. In 2015, the first iteration - SHS 1.0 - was estimated at over 61 million people worldwide experiencing at least 6 billion days of SHS annually as a result of life-limiting and life-threatening conditions. Objectives: In this paper, an updated methodology - SHS 2.0 - is presented building on the work of the Lancet Commission and detailing calculations, data requirements, limitations, and assumptions. Methods and results: The updates to the original methodology focus on measuring the number of people who die with (decedents) or live with (non-decedents) SHS in a given year to assess the number of people in need of palliative care across health conditions and populations. Detail on the methodology for measuring the number of days of SHS that was pioneered by the Lancet Commission, is also shared, as this second measure is essential for determining the health system responses that are necessary to address palliative care need and must be a priority for future methodological work on SHS. Conclusions: The methodology encompasses opportunities for applying SHS to future policy making assessment of future research priorities particularly in light of the dearth of data from low- and middle-income countries, and sharing of directions for future work to develop SHS 3.0.
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    Silver linings: a qualitative study of desirable changes to cancer care during the COVID-19 pandemic
    (European Institute of Oncology, 2021) Lombe, Dorothy; Sullivan, Richard; Caduff, Carlo; Ali, Zipporah; Bhoo-Pathy, Nirmala; Cleary, Jim; Jalink, Matt; Matsuda, Tomohiro; Mukherji, Deborah; Sarfati, Diana; Vanderpuye, Verna; Yusuf, Aasim; Booth, Christopher; Medicine, School of Medicine
    Introduction: Public health emergencies and crises such as the current COVID-19 pandemic can accelerate innovation and place renewed focus on the value of health interventions. Capturing important lessons learnt, both positive and negative, is vital. We aimed to document the perceived positive changes (silver linings) in cancer care that emerged during the COVID-19 pandemic and identify challenges that may limit their long-term adoption. Methods: This study employed a qualitative design. Semi-structured interviews (n = 20) were conducted with key opinion leaders from 14 countries. The participants were predominantly members of the International COVID-19 and Cancer Taskforce, who convened in March 2020 to address delivery of cancer care in the context of the pandemic. The Framework Method was employed to analyse the positive changes of the pandemic with corresponding challenges to their maintenance post-pandemic. Results: Ten themes of positive changes were identified which included: value in cancer care, digital communication, convenience, inclusivity and cooperation, decentralisation of cancer care, acceleration of policy change, human interactions, hygiene practices, health awareness and promotion and systems improvement. Impediments to the scale-up of these positive changes included resource disparities and variation in legal frameworks across regions. Barriers were largely attributed to behaviours and attitudes of stakeholders. Conclusion: The COVID-19 pandemic has led to important value-based innovations and changes for better cancer care across different health systems. The challenges to maintaining/implementing these changes vary by setting. Efforts are needed to implement improved elements of care that evolved during the pandemic.