Bridging critical disparities: A telementoring approach to equitable palliative care in Malaysia.

334

Background: Recent evidence shows substantial urban-rural disparities in palliative care access across Malaysia, with pronounced deficits in pain management, end-of-life care, and advance care planning. These gaps are most severe in home and community-based settings where vulnerable populations in rural areas face the greatest barriers to accessing quality care. Addressing this inequity need not depend solely on expanding specialist care. Emerging research demonstrates that generalist healthcare teams can deliver effective palliative care across diverse clinical competencies. Methods: Building on the evidence above, our study goal was to examine the effectiveness of a community palliative care telementoring program that provides continuous, case-based support to primary healthcare professionals in both urban and rural settings. We used a mixed -methods approach, deploying a mid-program survey, focus group discussions, and interviews with participants working in rural and urban areas. Between March and December 2025, more than 500 unique attendees, including doctors, nurses, and other healthcare professionals, participated in 10 virtual telementoring sessions. Results: All 53 program survey respondents (100%) reported implementing evidence-based practices in their clinical settings, with adoption rates exceeding 90% in psychosocial, emotional, and spiritual care needs; communication issues; patients’ physical care needs; assessment of patients and caretaker needs; as well as 70% in care planning and coordination. Qualitative data from interviews and focus group discussions provided deeper insights into best-practice uptake, revealing differential implementation patterns and context-specific challenges encountered by urban and rural healthcare providers. Participants across settings provided concrete examples of practice changes and subsequent patient improvements, demonstrating the program's capacity to translate evidence into action. Conclusions: These findings establish telementoring as a viable, scalable strategy for closing critical gaps in palliative care delivery nationwide, offering a replicable capacity-building model that leverages existing healthcare infrastructure rather than requiring prohibitively costly expansion of specialist services.