Palliative Care Research Milestones


For the program on palliative care, we used total morphine usage in the program as an indicator, similar to the way the World Health Organization (WHO) gauges progress in cancer pain management.


Our results revealed a 7-fold increase in morphine usage since 1993 when the program was started. In addition, the number of patients increased by 661% during the period from 1994 to 2006 owing to the increase in the number of trained health staff.


This study results were published as “Setting up home-based palliative care in countries with limited resources: a model from Sarawak, Malaysia.” Annals of Oncology 19: 2061-2066. 2008.

This paper was then selected by UICC for their Global News Alert  Feb Issue, Vol 3, Number 2, Feb 2009. The editors highlighted that caring for the terminally ill cancer patients in low and middle income countries can be a challenge when working in remote areas or with limited resources.


They commended that the model in Sarawak was both sustainable and cost efficient. The key components were training of nurses/healthcare workers and family members of patients to deal with pain management effectively and facilitate their access to pain medications as well as simplifying referrals to the oncology department.

In 2010, we published an updated version of our program in: “A model of palliative care program integrating rural with hospital care: Sarawak, Malaysia.” J Progress in Palliative Care 2010; Vol 18 (1): 31-36.

Our program is also incorporated into “Hospice and Palliative care in Southeast Asia: A review of developments and challenges in Malaysia, Thailand and the Phillippines”, by Michael Wright, Oxford University Press 2010.