Access to palliative care is part of the continuum of care outlined in Kyrgyzstan’s new systematic and comprehensive program approach to TB control. Palliative care is the patient-centred approach to care for chronically ill patients for whom treatment options are limited. Focusing on improving the overall quality of life of patients and their families, palliative care can be given at home or in hospitals.
People who have drug-resistant TB (M/XDR-TB) are not always comfortable in hospital settings, where they are surrounded by other people who are very ill. Chronically ill patients may now choose treatment on an outpatient basis, provided that their families are able to care for them and that appropriate infection control measures are taken. The main challenge to home-based palliative care is that the patients are likely to be highly infectious. Palliative care for people with TB is similar to palliative care for other diseases for which the care needs to be tailored to the specific needs of the patients. For example, there may be more need to alleviate breathing difficulties and less need for pain killing. Furthermore, as new drugs for treating TB emerge, new drug regimens may be administered to these TB patients. But the paramount concern is infection control.
Health workers and caregivers need special training to provide palliative care to this category of patients. In 2014 KNCV worked with the Postgraduate Institute (PGI) for continuous medical education to develop a training module for healthcare workers on TB-specific palliative care. Educational materials were also created to use when working with patients, caregivers and medical staff.