Estimating the Global Need for Palliative Care for Children

NCT ID: NCT02553148

Last Updated: 2016-02-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

18837613 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-06-30

Study Completion Date

2015-10-31

Brief Summary

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A cross-sectional analysis of prevalence data from a stratified sample of 23 countries used to estimate the global need for palliative care for children aged 0-19 years. Prevalence data, from the Institute for Health Metrics and Evaluation, was for 12 major diagnostic groups needing children's palliative care according to WHO and UNICEF guidelines.

Detailed Description

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There is growing awareness that there are major gaps in access to children's palliative care (CPC) worldwide. Adults have a greater likelihood of receiving palliative care than children. Growing access to treatment services, and extended periods of wellness have led to some changes in the nature of the palliative care services required. Children are more resilient and more likely to require CPC for longer periods than adults.

It is against this background that UNICEF and the International Children's Palliative Care Network (ICPCN), in collaboration with national palliative care associations, began a joint analysis to develop methods to assess critical needs and gaps in CPC. The initial assessment, conducted in Kenya, South Africa and Zimbabwe, aimed to analyse existing secondary data on palliative care to estimate the palliative care need amongst children and explore key gaps in the response with service providers. A report on this research, the methods used, and the results for South Africa was published in 2014.

There is a lack of information regarding the actual need for palliative care for children, and assessment is a complicated process, due to uncertainty about the patient population and the nature of palliative care for children. Although there have been some studies focusing on the status of CPC in sub-Saharan Africa and the United Kingdom, there are differences in the scope and approach to the present study. A systematic review of the provision of CPC around the world, noted that over 65% of countries have no recognised CPC service provision, and concluded that service provision for CPC is not meeting the need in the majority of the world.

Generally, studies estimating need for palliative care for children are based on mortality statistics for chronic, incurable illnesses. Estimates focused on end-of-life care, as in the Global Atlas of Palliative Care at the End of Life do not account for the children that need palliative care well before the last year of life and underestimate the need.

The World Health Organization defines palliative care for children as a special, albeit closely related field to adult palliative care. An effort to define the many diseases and conditions requiring CPC a directory was published in 2013 with 376 potential diagnostic labels though the majority of deaths were from a small number.

Conditions

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Cancer Congenital Anomalies Cardiovascular Disease HIV

Study Design

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Study Time Perspective

RETROSPECTIVE

Study Groups

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Argentina

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Armenia

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Australia

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Brazil

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

China

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Egypt

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Ethiopia

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Germany

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

India

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Indonesia

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Jordan

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Kenya

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Kyrgyzstan

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Malaysia

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Malawi

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Mexico

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Russia

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Serbia

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

South Africa

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Tajikistan

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

United Kingdom

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

United States

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Zimbabwe

One of the 23 countries studied

Need for children's palliative care

Intervention Type OTHER

Need for children's palliative care

Interventions

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Need for children's palliative care

Need for children's palliative care

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* have one of the conditions above

Exclusion Criteria

* greater than 19 years of age
Maximum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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UNICEF

OTHER

Sponsor Role collaborator

International Children's Palliative Care Network

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Joan Marston, MA, RN

Role: STUDY_CHAIR

International Children's Palliative Care Network

Stephen R Connor, PhD

Role: PRINCIPAL_INVESTIGATOR

International Children's Palliative Care Network

Locations

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International Children's Palliative Care Network

Fairfax Station, Virginia, United States

Site Status

Countries

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United States

References

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Institute of Medicine (US) Committee on Palliative and End-of-Life Care for Children and Their Families; Field MJ, Behrman RE, editors. When Children Die: Improving Palliative and End-of-Life Care for Children and Their Families. Washington (DC): National Academies Press (US); 2003. Available from http://www.ncbi.nlm.nih.gov/books/NBK220818/

Reference Type BACKGROUND
PMID: 25057608 (View on PubMed)

Harding R, Brits H, Penfold S. Paediatric antiretroviral therapy outcomes under HIV hospice care in South Africa. Int J Palliat Nurs. 2009 Mar;15(3):142-5. doi: 10.12968/ijpn.2009.15.3.41093.

Reference Type BACKGROUND
PMID: 19537535 (View on PubMed)

Connor S, Sisimayi C, Downing J, King E, Lim Ah Ken P, Yates R, Marston J. Assessment of the need for palliative care for children in South Africa. Int J Palliat Nurs. 2014 Mar;20(3):130-4. doi: 10.12968/ijpn.2014.20.3.130.

Reference Type BACKGROUND
PMID: 24675539 (View on PubMed)

Hain R, Heckford E, McCulloch R. Paediatric palliative medicine in the UK: past, present, future. Arch Dis Child. 2012 Apr;97(4):381-4. doi: 10.1136/archdischild-2011-300432. Epub 2011 Oct 28.

Reference Type BACKGROUND
PMID: 22039176 (View on PubMed)

Fraser LK, Miller M, Hain R, Norman P, Aldridge J, McKinney PA, Parslow RC. Rising national prevalence of life-limiting conditions in children in England. Pediatrics. 2012 Apr;129(4):e923-9. doi: 10.1542/peds.2011-2846. Epub 2012 Mar 12.

Reference Type BACKGROUND
PMID: 22412035 (View on PubMed)

Knapp C, Woodworth L, Wright M, Downing J, Drake R, Fowler-Kerry S, Hain R, Marston J. Pediatric palliative care provision around the world: a systematic review. Pediatr Blood Cancer. 2011 Sep;57(3):361-8. doi: 10.1002/pbc.23100. Epub 2011 Mar 17.

Reference Type BACKGROUND
PMID: 21416582 (View on PubMed)

Hain R, Devins M, Hastings R, Noyes J. Paediatric palliative care: development and pilot study of a 'Directory' of life-limiting conditions. BMC Palliat Care. 2013 Dec 11;12(1):43. doi: 10.1186/1472-684X-12-43.

Reference Type BACKGROUND
PMID: 24330676 (View on PubMed)

Other Identifiers

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0001

Identifier Type: -

Identifier Source: org_study_id

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