LAUSR

Respected Editor, We thank the authors of the article “Socioeconomic and racial/ethnic disparities in receipt of palliative care among patients with metastatic hepatocellular carcinoma” for their insightful article on the understanding the racial and socioeconomic characteristics as a cause of disparities in the palliative care management of cancer patients. Based on their conclusion statement “Targeted efforts should be enacted to increase the delivery of Palliative Care in this group,” we would like to discuss a tangible set of possibilities that come from rural settings and limited resources for palliative care accessibility (Figure 1). First, the study on rural palliative care conducted in rural North India by Munday et al., highlights the creation of a program using the mixed method approach (MMA). Two extremely important highlights of their approach were: Community engagement‐community volunteers and Building trust and relationships in the community. It was evident that MMA teams needed to work on building trust and relationships in the local community due to cultural differences and sometimes language difficulties that posed a challenge for the teams. The nurses and doctors of the palliative care team were mostly not from the communities in which they worked and relied on nursing assistants and drivers to assist them in understanding local customs. Engaging and involving local men and training them to provide palliative care services showed strong positive results, rather than uninvolved MMA. This was built on the community relationships of trust and health between the limited working staff and rural habitants. Second, a study conducted in Canada by Pesut et al. resulted in the creation of a model on rural palliative supportive service (RPaSS) for older adults living with chronic life‐limiting diseases. The findings of this study show that providing home‐based treatment for rural older persons with chronic life‐limiting disease is feasible. By providing a continuous source of support and education across the disease trajectory and across all care settings, the RPaSS approach has the potential to smooth transitions and improve quality of life. This form of consistency has the ability to develop the patient‐ and family‐centered approach to treatment that a palliative approach seeks. Finally, another interesting model by Moncho et al. on comprehensive palliative care through home palliative care units (HPCU) showed promising results. Patients receiving HPCU assistance have fewer emergency room visits and hospital admissions, and are more likely to die at home. Taken together, these results support the relevance of HPCU in providing high‐quality care to cancer patients. Meanwhile, in another article, Sibold et al. demonstrated that previously developed short animated videos describing basic chemotherapy terminology may improve patient understanding in an underserved urban setting. This could be also modified based on language and cultural characteristics to make people from a rural setting/resource‐limited setting understand terms and concerns of palliative care therapy in cancer patients, since the complex terminology can be confusing to patients and their local caregivers. These mentioned models and examples of palliative care between inaccessible case zones in low‐cost and resource‐limited settings draw our attention to the palliative care provided to individuals suffering from oncological problems (Figure 1). We thank the authors on their studies and possible models for the elaboration and implementation of new public health policies in this field. Moreover, we suggest further studies to compare different models and different approaches that could be tested to create a global standard of palliative care in resource‐limited settings.