Contribution of Eastern Mediterranean Region countries to palliative care journals from 1991 to 2020 and its relationship to the development of palliative care

Abstract

Background Palliative care (PC) is in an early stage of development in the Eastern Mediterranean Region (EMR) of the World Health Organization. A metric based on publishing in specialized PC journals may be useful in assessing PC development. This study was conducted to describe the contribution of EMR countries to PC research and to study the relationship between this contribution and the levels of PC development. Methods The Scopus database was used to search 21 PC journals (1991–2020) for articles with at least one EMR-affiliated author independently of his/her position in the article. As an indicator, the 3-year average articles per million population per year (AAMY) was calculated. Changes over time were calculated through a regression analysis. The relationship between the AAMY and the level of PC development and opioid consumption were assessed through Mann-Witney test using the worldmap PC development categories as a proxy, and Spearman analysis, respectively. Results The number of articles published during the 30-year period was 31,108 of which 402 (1.3%) were EMR-affiliated. There was a steady rise in the AAMY of the EMR (R2 = 0.894). The number of EMR-affiliated articles increased from 3 in the period 1991–1995 to 191 in 2016–2020. The 2018–2020 AAMY was significantly higher in countries with greater PC development than in those without (median [IQR] = 0.0975 [0.0254–0.1802] and 0.0098 [0–0.0256], p = 0.042). Also, it was significantly higher in countries that progressed to a higher level of PC development between 2006 and 2017 (p = 0.0159). There was a significant positive correlation between the average opioid consumption for the years 2017–2019 and the AAMY for the same period (p = 0.0043). Conclusions There is a slow steady progress in the contribution of EMR countries to PC journals, which corresponds to the level of PC development and its progress in the region. A metric based on the contribution to specialized PC journals may be a useful indicator of PC development.

Palliative care journal publications by country as a metric for palliative care development level

“…To the best of our knowledge, this is the first study to test a metric based on PC research output for the assessment of PC development at a global level. Other studies assessed the PC research output at regional levels in Africa,5 Asia Pacific,4 South America11 and Eastern Mediterranean regions 12…”

“…The PubMed database is one of the databases suggested by the WHO as a source for the development of a scientific publishing PC indicator 2. Taking it as an example, searching the PubMed database using ‘palliative care’ as a ‘MeSH Major Topic’ without limits yields 5205 publications for the years 2016–2018 12. A search using ‘palliative care’ as a ‘MeSH term’ without limits yields 7290 publications 13.…”