Student, faculty member study pediatric palliative care in Uganda

When Matthew Quillen, an undergraduate student studying Health Policy and Administration, signed on to assist Associate Professor Caprice Knapp with her research on children’s palliative care, the medical school hopeful admits he knew little about the issue.

“It was a different, yet vital, aspect of medicine that I was interested in adding to my area of study,” Quillen said.

For a year, Quillen, Knapp and Julia Downing, Honorary Professor at Makerere University, Uganda, and director of education and research at International Children’s Palliative Care Network (ICPCN), planned out the study of pediatric pain management in Uganda for ailments such as HIV, sickle cell disease and cancer.

The purpose was to determine if three children’s palliative care programs in Uganda were using the World Health Organization’s Two-Step Pain Ladder for children with persistent pain. The two-step plan includes first using pain relievers such as Tylenol or Codeine before then utilizing opioids, such as morphine.

In August, Downing guided Knapp and Quillen as the trio spent time at Mildmay, Hospice Uganda and Mulago Hospital reviewing medical charts, conducting interviews with health care workers, and identifying documentation used in pain assessment and management.

“By reviewing charts and interviewing health care workers first hand, I was able to further understand how each site assessed, treated, and managed different kinds of pain,” Quillen said “It was interesting to realize the similarities and differences between each location while recognizing the alignment between interviewee’s responses and chart information.” 

The long-term goal is to determine if the WHO guidelines are effective, particularly in a country with limited resources, Knapp said. The next goal for researchers is to conduct a study in a country where morphine is not readily available, such as Armenia or India.

“This is a first step in a series of studies where we hope to answer the question: are these guidelines effective at reducing pain,” said Knapp. “Uganda is the best starting situation because the country has been using the guidelines to demonstrate it can be done and done in an environment with limited resources.”

Additionally, lessons learned from this project will be helpful to ICPCN as they work with international experts on issues related to pain. 

“The beauty of this project is that it showcases what researchers can accomplish by collaborating with ICPCN and involving students,” Knapp said. “By involving students in research and introducing them to children’s palliative care we are building the next generation of advocates, clinicians, and researchers.”

Quillen said, “Traveling to Uganda was an amazing first-time-abroad experience. This project not only offered me a differing perspective of the care delivered overseas, but provided me unique experiences that I will take with me on my journey in medicine. I would also like to thank both Dr. Knapp and Dr. Downing for their continued support and the opportunity to join them on such a wonderful research experience.”

Quillen wrote about the experience for the Penn State Africana Research Center's travel blog, which published Friday, Feb. 5.

Matt Quillen with tour guide in Uganda

Undergraduate student Matthew Quillen poses with his tour guide at a market in Uganda. 

Image: Caprice Knapp

Downing appreciated the opportunity to work with the Penn State team and she hopes to collaborate with Penn State again in the future.

“It was exciting that we were able to undertake this preliminary research in Uganda and we hope that it will lead on to further work looking at managing pain in children’s palliative care and the use of the two-step analgesic ladder,” Downing said.

 

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Last Updated February 24, 2016