OTHER-03 A COMPARATIVE ANALYSIS OF BRAIN TUMOR PALLIATIVE CARE PRACTICES IN CAMEROON AND NIGERIA

Early access to palliative care is essential in management of brain tumor patients, particularly given low rates of survival despite optimal therapies. This is especially true in resource limited areas such as sub-Saharan Africa, where treatment options are further limited. A palliative care questionnaire was distributed to 72 physicians in Nigeria and 37 physicians in Cameroon who treated brain tumor patients. Significantly more participants from Nigeria expressed understanding of palliative care (90%), compared with the participants from Cameroon (35%), with more Nigerian participants reporting prior education in palliative care (58% compared with 27%). Participants from Nigeria were also much more comfortable initiating discussions, addressing concerns, providing consultations, and prescribing palliative medication (93%, 76%, 56%, and 71% respectively) compared with participants from Cameroon (65%, 41%, 32%, and 47% respectively). Participants from Nigeria were more likely to address pain, dysphagia-related symptoms, and anxiety (81%, 87%, and 72% respectively) compared with participants from Cameroon (69%, 50%, and 51% respectively). They were less likely to delay palliative care, with 47% waiting until evidence of irreversible deterioration compared with 62%. Participants from both Cameroon and Nigeria expressed limitations in access, with approximately 40% reporting no access to palliative care, and access to liquid opioids was particularly limited in Cameroon, with over 60% reporting no access. Additionally, many participants in both countries reported that cultural beliefs of both the provider and patient had an impact on palliative care delivery. Overall, this analysis helps to further characterize the country-specific challenges in palliative care delivery in sub-Saharan Africa and may assist in developing a framework for meeting brain tumor patient needs.