Palliative care highlighted at the WONCA, Special Interest Group in Brazil, November 2016

This pre-conference WONCA SIG attracted a large group, including many Brazilians eager to hear about palliative care in the community internationally.  

Prof Geoff Mitchell first welcomed everyone and explained the vision of the SIG and of the International Primary Palliative Care Network which had members in every continent.

Prof Scott Murray then highlighted the recent WHO manual on integrating palliative care in all settings, especially the community.  He had contributed to this very useful manual which spells out how palliative care can be integrated in primary care in various high, middle and low income countries.

Then Dr Santiago Correa illustrated how his project in Brazil works so that others could learn from it. See link to EAPC blog. This was received very enthusiastically.  The new President of WONCA, Professor Amanda Howe, visited the special interest group and encouraged us to continue over the next few years in this priority area for primary care.  

During the WONCA conference itself we held a “basics of palliative care” session for GPs which lasted 3 hours.  Daniel Azevedo and Claudia Buria, both from Brazil, presented in a very dynamic fashion key issues about identifying and helping people with frailty and dementia.  Geoff Mitchell then gave a clear basic talk on symptom control.  Again there was much enthusiasm around this.

On the last day of WONCA Brazil there was a special panel on palliative care when we heard presentations from Geoff Mitchell (summarising palliative care in Latin America using a presentation from Dr Liliana deLima (USA), Maria Goretti Sales (Brazil), Thomas Martin (Costa Rica), and Santiago Correa (Brazil)  In closing,  Scott Murray (UK) who showed a 4 minute video giving a 4 dimensional rationale for early palliative care which was well received, and which soon should be available as a teaching aid for students and postgraduate teaching for nurses, doctors and allied health professionals.  

There will be great opportunities for further palliative care input at WONCA in Seoul in 2 years’ time and in regional conferences before then.  Meanwhile the SIG and International palliative Care Network are going ahead to help different countries to integrate palliative care in primary care, using the Toolkit  developed by the EAPC Taskforce and WONCA in 2016.

Scott Murray, Co-chair of WONCA cancer and Palliative Care SIG.

• A very personal (and professional) reflection by Scott Murray on the importance of early palliative (or anticipatory) care was published in the June edition of the BMJ.
• The March edition of the Scandinavian Journal of Primary Healthcare have published an article by Trine Brogaard, Mette Neergaard and Scott Murray, which describes calls for primary palliative care throughout Scandinavia!
• In the March edition of EJPC Santiago Corrêa et al describes the initiative ‘We are by your side’ that he has been involved in to formalise primary palliative care in Brazil. 
• A review article by Afshar et al. from Germany elucidates the importance of optimising the identification of non-cancer patients in need of palliative care in general practice.
• Two recent publications from Canada have helped to put the spotlight on the value and enablers of home deaths. Results of a multi-province study involving 60,000 cancer patients in their last month of life, found that investment in home-based palliative care reduces overall costs to the health care system. The link to this article by Burge and Lawson et al published in Current Oncology is available here. 
• The second article also by Burge and Lawson et al, published in the Journal of Palliative Medicine, addressed the congruence between the last preferred and actual location of death among adult Nova Scotians who died from chronic disease. They identified emotional needs being met, nursing and family physician home visits, palliative care program involvement, and being at home for the majority of the last month as independent contributing factors to achievement of a home death among those who voiced the desire to do so.