Dual passion of Dr Marlise Poolman: Clinical work and palliative care research

Dr Marlise Poolman, an esteemed Health and Care Research Wales funding awardee and researcher at the North Wales Centre for Primary Care Research, has dedicated her career to clinical practice and pioneering research in palliative care.

Her journey into this field is both inspiring and deeply rooted in the personal satisfaction of seeing her research implemented and patient care improved.

Early career

Marlise began her medical education in South Africa, with a clear ambition to specialise in endocrinology, the study of hormones. After moving to the UK, she secured a rotation in South Wales, which she saw as a crucial step towards her dream as it shaped the future of her career.

During her residency, she encountered palliative care for the first time, an experience that profoundly changed her path. Her patients were in the last stages of their lives and their experiences touched her deeply. Some bravely faced their own death, while others expressed fear or gratitude for the small comforts Marlise could provide.

"I can remember those first two weeks at the hospice coming back crying every night.

“By the second week, I said to my husband, crying once again: This is my specialty. This is what I want to do.”

Embracing palliative medicine

Despite having no formal training in palliative care during her studies in South Africa, Marlise found herself drawn to the specialty. The emotional impact of end-of-life care revealed to her the importance of this field.

“It came to me.

“I always thought perhaps I am more of a scientist and a researcher and maybe I should have studied chemical engineering and should never work with people but I'm grateful for palliative care as my specialty because it got me to engage with people at the end of their life a time when people are most vulnerable.”

This realisation marked the beginning of her commitment to palliative care, both in clinical practice and research. Marlise then proceeded to secure the NHS Research Time Award from Health and Care Research Wales which kickstarted her research career.

Balancing clinical work and research

Marlise's dual focus is evident in her professional accomplishments. She is passionate about working directly with patients while also advancing palliative care through research. Her work is centred on supporting people who wish to die at home, a research area that brings her immense satisfaction. This hands-on approach allows her to directly observe the positive outcomes of her research.

The CARiAD study

The CARiAD study (CARer-ADministration of as-needed sub-cutaneous medication for breakthrough symptoms in home-based dying patients) led by Dr Marlise focused on empowering caregivers with the knowledge and skills to administer medications to manage their loved one's symptoms at home, so it’s more likely they will die in that environment. Carers are supported by healthcare professionals and trained on how to recognise symptoms, how to give injections and then see if they work to relieve the symptoms.

This innovative approach has not only improved patient comfort and wellbeing but also alleviated the burden on healthcare professionals during the pandemic. While the CARiAD study is now gaining traction throughout the UK, Wales was first to implement this approach in early 2020.

Marlise continued:

“The policy was implemented within a week into the pandemic Wales was first. The first country in the world to implement this approach to end-of-life care on such short notice.”

Impact

By training the carers effectively, the study has:

• Reduced waiting times for symptom control which significantly improves patients’ comfort
• Increased the confidence of carers and made them feel involved and supported in caring for their friend or family member
• Provided a new model of care which inspired the adoption of this approach throughout the UK.

Recognitions

Dr Poolman and her team received the Health and Care Research Wales 2023 Innovation in Practice Award for their work. This award recognised the ways in which research teams and individuals have made an impact during development, delivery or implementation of their research and the value it has brought to people’s lives.

Dr Poolman acknowledges the invaluable contributions of the entire team, highlighting this project as a collective effort of many people, she said:

“This award is not just for me – it's for all of us. Without everyone on the team, we would not be able to pull this off.”

Next steps

Looking ahead, Marlise remains committed to the path of research and clinical practice. She values the ability to see her research implemented in real-world settings, which she describes as a "privilege."

Explore Health and Care Research Wales Faculty pages to find out the right funding opportunities or awards for you and kickstart your research journey. You can also watch a Faculty webinar focused on experiences and insights from re-applying for research funding with Dr Marlise Poolman.