EAPC - ipac

428 EAPC Abstracts
the Diana Fund, IPCI and the National Hospice and Palliative Care
Organization to support research on palliative care in Africa. Individual
country initiatives in Britain, the United States and Canada, both governmental
and non-governmental, have given some priority to palliative care
research as well. There is enormous need to attempt to codify and clarify
the current status of research in palliative care funding throughout the world
to assess the percentage of palliative care funding compared to others.
95 Invited Lecture
How to improve research funding and capacity building in a
world wide perspective
How to improve research funding and capacity building in a
world wide prospective
Australian National Initiatives
Authors: David Currow Palliative & Supportive Services Flinders
University AUSTRALIA
In order to improve the evidence base for quality palliative care, it is necessary
to invest in research infrastructure. Given the nature of research in
palliative care, multi-site studies are absolutely crucial to refine the practice
to specific subgroups of the population. As such, the Australian
Government together with other national organisations have cooperated to
create significant palliative care research infrastructure. This includes: – A
dedicated grants program through the National Health and Medical
Research Council; – A competitive Doctoral program; – A national program
to improve the evidence for prescribing palliative medications (including
their cost effectiveness and safety); – Infrastructure for multi-site data.
Together, this investment represents an ability of the palliative care community
to build capacity for quality research while answering practical questions
on day to day service delivery and therapeutics.
96 Invited Lecture
How to improve research funding and capacity building in a
world wide perspective
How to improve research funding and capacity building in a
world wide prospective:
Canadian National Initiatives
Authors: Neil Hagen Division of Palliative Medicine University of Calgary
CANADA
Canada has experienced a remarkable national growth in palliative care
research funding and capacity over the past decade. This situation resulted
from alignment of several distinct cultural, political and organizational
changes, and strategically targeted activities from key non-governmental,
professional and governmental organizations. Cultural changes in Canada
have included an emerging grass-roots public interest in palliative and end
of life care. Political factors involved major initiatives by the Senate of
Canada, culminating in a pivotal report in 2000, “Quality end of life care,
the right of every Canadian” which has continued to impact national and
provincial policy since. The establishment of a new national health
research organization in 2001, the Canadian Institutes for Health Research
(CIHR), offered the opportunity to shape national priorities in research,
and in 2002 it identified palliative and end of life care as its top cancer
research priority. Non-governmental organizations such as the Canadian
Cancer Society, and numerous professional groups such as the Canadian
Society of Palliative Care Physicians, advocated for this and related developments.
In 2003 the CIHR earmarked $16.5 million dollars toward New
Emerging Teams grants in palliative care, and a total of 10 multicenter
teams were awarded five-year grants. The focus of these teams ranged
from pediatrics to geriatrics, from difficult pain problems to delirium, and
most major academic health care organizations in Canada involving the
entire range of professionals including physicians, nurses, psychologists,
and basic through clinical researchers, have become engaged in these initiatives.
However, it has been challenging for the palliative care research
community to develop the level of maturity needed to sustain such national
activity and growth. This presentation outlines the major factors that
contributed to national successes to date, barriers we encountered and
future challenges we face.
97 Invited Lecture
How to improve research funding and capacity building in a
world wide perspective
How to improve research funding and capacity building in a
world wide prospective
Latin American National Initiatives
Authors: Jorge Hugo Eisenchlas Palliative Care Unit Pallium
Latinoamerica ARGENTINA
Research in palliative care has increased significantly in the last decade,
but while more than 80% of the global disease burden occurs in
developing countries, the proportion of research conducted in these
settings accounts for less than 10 per cent of all global research activity. In
Latin America, in spite of the increase of palliative care initiatives across
the region, research efforts are still very limited. Consequently, there is a
lack of local evidence which on one hand, plays against knowledge
advance and practice improvement and, on the other hand, complicate the
institution of policies able to improve palliative care delivery. Altogether,
these factors form a vicious circle which results in limited visibility of
palliative care, which results in limited political support and funding. We
have now a broad view concerning what happens in the region, and we also
have a supportive document, like the Declaration of Venice. It is crucial
that recommendations and proposals take into account feedback provided
not only by donors but also local leaders from developing countries, who
are the best source of information about the needs, challenges and barriers
present at the local level.
98 Invited Lecture
How to improve research funding and capacity building in a
world wide perspective
How to improve research funding and capacity building
Authors: Stein Kaasa Palliative Medicine Unit St. Olav’s Hospital NORWAY
Palliative Care research has been steadily improving during the last
decade. Despite these improvements national and international evaluations
have identified several limitations and areas for improvement, ranging
from the laboratory bench to the bed side and into the health care policy
arena. – Improved understanding of the basic biological mechanisms
behind symptoms; – Symptom classification – common international
system; – Symptom assessment – common international assessment tools;
– Research staff; Training of junior researchers; Permanent chairs in palliative
medicine, palliative care nursing and other areas. – Establishment of
sustainable research groups of sufficient size with interdisciplinary knowledge
and capacity; – Improve the quality of the research conducted – move
from descriptive studies to intervention studies; – To develop national and
international partnership; – Apply the optimal research methodology fitting
the research question. There are substantial barriers to research to reach
some of the items addressed. Some barriers are found within the systems
of palliative care, such as scepticism in many clinical environments
towards research and the lack of prioritizing research. These we need to
address ourselves. Others are found on the arena where Palliative Care
collaborates with other parts of the health care system, other professions
and even outside health care environment. Here we need to ask the right
questions in order to fertilize collaboration. Economically we need to
produce high quality research in funded research groups within several
countries in the world in order to ensure long lasting funding, nationally
and internationally.