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Making supportive care a priority

“So how do you feel about being awarded the National Medical Research Council (NMRC)’s Transition Award?”

“Really honoured and very grateful as it is the first time that the transition award has been given to a palliative medicine clinician,” said Assistant Professor Grace Yang, a Consultant in the Division of Supportive and Palliative Care (DSPC) at the National Cancer Centre Singapore (NCCS) and the Department of General Medicine at Sengkang General Hospital.

Palliative care is going through a transition in Singapore. In the past, a patient was only referred to palliative care when no other treatment could be provided to control the cancer, and when a patient was deemed to be “terminal”. Nowadays, palliative care clinicians are involved in providing supportive care for patients, alongside chemotherapy and other cancer-directed therapy.

The clinicians in the DSPC work as part of the clinical care team and look at how to provide holistic care to a patient. They assess and provide support based on how a patient’s disease and treatment impacts their quality of life. This includes helping patients manage symptoms and side effects from treatment, and offering counselling and patient support groups to manage emotional or social problems. They also help with planning for discharge and care at home and teach caregivers how to best care for their loved ones at home, which is an important component of the support they offer patients and their families.

In 2018, the Division of Palliative Medicine at NCCS was renamed the Division of Supportive and Palliative Care to reflect its expanded role and the changing needs of patients.

Research in this field is essential to innovate and develop novel models of supportive and palliative care, that can reach more patients earlier in their care journey. As NCCS and Singapore moves toward embracing patient-centeredness and prioritising quality of life as a goal of treatment outcomes, research helps to demonstrate how effective models of care can be implemented in routine clinical practice.


Asst Professor Grace Yang, Consultant, with her team in the Division of Supportive and Palliative Care, National Cancer Centre Singapore

Behind the Transition Award

The NMRC awarded Asst Prof Yang the Transition Award for her proposal to conduct a randomised controlled trial of the SPARKLE or ‘Supportive and Palliative care Review Kit in Locations Everywhere’ intervention. The SPARKLE intervention is an outpatient-based model of early palliative care that aims to meet the needs and improve the care of patients in the community.

Palliative care is often inadequate and delivered to patients too late. This is because there is limited specialist palliative care manpower and existing care models are manpower-intensive. The SPARKLE intervention aims to address those shortcomings by delivering care to patients with advanced cancer alongside their usual oncologist-led care.

SPARKLE comprises regular symptom monitoring using online questionnaires, that allow for early identification of problems and prompt treatment of the problems that are identified. A link to the brief online questionnaire is sent to patients via phone text message regularly. Since administration of these questionnaires do not require specialist manpower, there is a low per capita cost, which allows a large number of patients to be monitored. Proactive screening for problems facilitates earlier supportive and palliative care interventions for advanced cancer patients, whenever the need arises.

Asst Prof Yang and her team aim to improve the quality of life for advanced cancer patients and their caregivers with the SPARKLE intervention. The trial was on hold due to the COVID-19 pandemic in 2020 and will resume in early 2021.