DOI: 10.1177/21501319241237058 ISSN: 2150-1319

Perceptions of Learners and Specialists Toward ECHO Palliative Care Project in Thailand

Nida Buawangpong, Lalita Chutarattanakul, Nisachol Dejkriengkraikul, Alicha Chumintrachark, Thawalrat Ratanasiri, Kanokporn Pinyopornpanish, Nopakoon Nantsupawat, Chaisiri Angkurawaranon, Wichuda Jiraporncharoen
  • Public Health, Environmental and Occupational Health
  • Community and Home Care


The Extension of Community Health Outcomes (ECHO) is a global movement that aims to decentralize the knowledge of specialists to primary care. A pilot, ECHO palliative care project in Thailand, was introduced to enhance the implementation of palliative care practice.


To assess learners’ and palliative care specialists’ perceptions toward the ECHO palliative care project to improve and expand the project in the future.


A total of 15 hospitals in 7 provinces in Northern Thailand, including provincial and district hospitals.


A qualitative study was conducted among learners (primary care providers) and palliative care specialists who participated in the pilot program. Semi-structured interviews were used to explore the potential impact of the project on clinical practice, the strengths and weaknesses of the ECHO program and platform in the Thai context, and suggestions for expansion. Thematic analysis was used for qualitative analysis. Pre- and post-confidence scores, using a 5-point Likert Scale, for palliative care practice among learners were analyzed using paired T-tests.


Twenty participants were interviewed: 15 learners and 5 palliative care specialists. The confidence in practicing palliative care after participating in the ECHO palliative care project significantly increased for the learners, from 2.93 (95% CI, 2.49-3.38) to 3.93 (95% CI, 3.68-4.19) points ( P = .003). Three themes emerged through the process evaluation of the pilot ECHO palliative care project: (1) applicable lessons that can translate to practice, (2) an effective learning program and assessable platform, and (3) suggestions for expansion.


The ECHO palliative care project increased confidence in providing palliative care for primary care providers in Thailand. Through capacity building, participants reported applying the knowledge to improve local health services and develop a network for consultations and referrals. There is potential for expansion of the ECHO palliative care project in Thailand.

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