Reciprocal Innovation – Facilitating Home Hospice Care Via Telecommunication in Kenya2020-08-12T09:46:19-04:00

Facilitating Home Hospice Care Via Telecommunication in Kenya

Principal Investigator Dr. Ken Cornetta
International Collaborator(s)
Project Title Facilitating Home Hospice Care Via Telecommunication in Kenya
Priority Area Access to healthcare
The Intervention The vast majority of patients in Western Kenya lack access to home hospice services. To help manage symptoms, the palliative care service within AMPATH-Oncology provides 24-hour phone support for patients in their family. Use of the phone is predominately patient or family initiated. This Process Improvement Program seeks to pilot a phone monitoring program to optimize control of pain and other symptoms common to patients with advanced care. The data collected will be key to better understanding the needs of palliative care patients discharged to home and can serve as an important baseline dataset for future research studies. This project provides baseline data for developing telecommunication for home-based hospice. The project will capitalize on the ongoing collaboration between the palliative care program at MTRH in Eldoret, Kenya and palliative care physicians at Indiana University. Utilizing telecommunications to improve palliative care in rural settings in Kenya have large potential impacts on implentation in the US an providing patients in rural settings in Indiana with access to palliative care.
Key Facilitators This intervention is being piloted in Kenya with support of the public health system run by the Kenyan Ministry of Health. The Indiana CTSI is developing a program focused on reciprocal innovation that seeks to support the indentification, adaptation, implementation, and evaluation of promising interventions developed at LMIC partner sites for use in Indiana. This infrastructure provides funding and other resoruces to adapt interventions to a US context.
Target Population For the project, 30 subjects with high symptom burden requiring morphine for symptom management were included. Patients were recruited from individuals referred by MTRH oncologists and inpatient physicians to PC. Prior to consideration for enrollment, patients had been assessed by the PC team. Medication dosages, including dosages of morphine, were determined prior to enrollment. For each enrollee, a Patient Intake Form was completed by a trained PC Team Member to assess demographics and diagnosis.
Process to Implementation This intervention has not yet been implemented in Indiana but is being piloted in Kenya. If the pilot findings show positive outcomes, potential exists to apply this intervention to low resourced clinical settings and rural patients in Indiana and the US. Following identification of potential pilot sites in Indiana, this intervention could be adapted and piloted for use in the US clinical context using support from the Indiana CTSI and other health partners in Indiana, e.g. State Department of Health, IU Health, Eskenazi, and other public health centers.
Key Stakeholders There were clinical partners, including doctors, nurses, etc. that helped with the intervention, patients, Ministry of Health stakeholders. We anticipate in transferring to the US that there would need to be similar stakeholders that would need to be engaged within the health systems.
Scaled or Transferred? The aim is to work toward scaling this process into the US setting
Type of Research Implementation science was utilized. The expected outcomes will be important baseline data for developing telecommunication for home-based hospice. The project will capitalize on the ongoing collaboration between the palliative care program at MTRH in Eldoret, Kenya and palliative care physicians at Indiana University. Future research projects would include improving symptom management, developing novel psychosocial support through telecommunication including bereavement services, and optimally expanding the model developed here throughout other low or middle income countries.
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