• Semra Ozdemir, Jia Jia Lee, Grace Meijuan Yang, Chetna Malhotra, Irene Teo, Nguyen Tuong Pham, Maria Fidelis Manalo, Thushari Hapuarachchi, Lubna Mariam, Rubayat Rahman, and Eric Finkelstein.
• Lien Centre for Palliative Care (S.O., J.J.L., M.Y., C.M., I.T., E.F.), Duke-NUS Medical School, Singapore; Programme in Health Services & Systems Research (S.O., J.J.L., C.M., I.T., E.F.), Duke-NUS Medical School, Singapore. Electronic address: semra.ozdemir@duke-nus.edu.sg.
• J Pain Symptom Manage. 2022 Oct 1; 64 (4): e195-e201.

ContextTo date, little is known about palliative care (PC) awareness and utilization in low- and middle-income countries (LMICs) in Asia.ObjectivesThis study aimed to investigate PC awareness and its predictors, utilization of PC services, and perceived utilization barriers among advanced cancer patients from select hospitals in Asian LMICs.MethodsThis cross-sectional study analyzed data of 759 advanced cancer patients at major hospitals of four LMICs in Asia (i.e., Bangladesh, Philippines, Sri Lanka, and Vietnam). The predictors of PC awareness were investigated using multivariable logistic regression.ResultsOverall PC awareness was 30.8% (n = 234). Patients with higher education (OR = 1.0; CI = 1.0,1.1), from upper-middle or high-income households (compared to low-income) (OR = 2.0; CI = 1.2,3.3), awareness of disease severity (OR = 1.5; CI = 1.0,2.2), and higher pain severity (OR = 1.1; CI = 1.0,1.2) had higher odds of PC awareness. Compared to patients who perceived themselves as being very informed about disease trajectory, those who were unsure (OR = 0.5; CI = 0.3,0.8) or uninformed (OR = 0.5; CI = 0.3,0.9) had lower odds of PC awareness. The PC utilization rate was 35.0% (n = 82) among those with PC awareness, and 47.8% (n = 66) among patients recommended PC by a healthcare professional (n = 138). The most cited PC utilization barriers were currently receiving anti-cancer treatment (n = 43; 33.9%), and having insufficient information about PC (n = 41; 32.3%).ConclusionThe low awareness of PC services in these major hospitals in Asian LMICs highlights that more effort may be required to promote the awareness of PC in this region. The efforts should especially focus on those from disadvantaged groups to reduce the gap in PC awareness.Copyright © 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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