The change over time of vital signs with consideration for opioid use in the last 2 weeks of life among cancer patients in a palliative care unit: Continuous measurement of vital signs using a non‐wearable monitor

This study aimed to investigate the effect of music on pain, anxiety, comfort, and functional capacity of cancer patients who received care in a palliative care unit. The population of this randomized controlled trial consisted of cancer patients hospitalized in the palliative care service between July 2018 and July 2019. The study included 60 patients (30 interventions/30 controls). The patients in the intervention group were given a total of six music sessions, 10 minutes each with the Turkish classical music in maqams of their choice (Hejaz or Rast accompanied by an expert tambour (drum) player). There was a significant difference between the mean total pain scores, anxiety, comfort, and functional capacity scores of the patients in the intervention and control groups before and after music therapy. Music therapy decreased the level of pain. It is demonstrated that Turkish classical music therapy improved the pain, anxiety, comfort, and functional capacity in the palliative care unit.

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Predicting Place of Death of Elderly Cancer Patients Followed by a Palliative Care Unit

Journal of Pain and Symptom Management ◽

10.1016/s0885-3924(01)00283-4 ◽

2001 ◽

Vol 21 (6) ◽

pp. 481-490 ◽

Cited By ~ 18

Author(s):

Anna Maria Izquierdo-Porrera ◽

Jordi Trelis-Navarro ◽

Xavier Gómez-Batiste

Keyword(s):

Palliative Care ◽

Cancer Patients ◽

Palliative Care Unit ◽

Place Of Death ◽

Elderly Cancer Patients

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The PROVIEW+ tool: Developing and validating a tool to predict risk of poor performance status and severe symptoms in cancer patients over time.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.12095 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 12095-12095

Author(s):

Hsien Seow ◽

Rinku Sutradhar ◽

Lisa Catherine Barbera ◽

Peter Tanuseputro ◽

Dawn Guthrie ◽

...

Keyword(s):

Decision Making ◽

Palliative Care ◽

Cancer Patients ◽

Severe Pain ◽

Performance Status ◽

Well Being ◽

Assessment System ◽

Low Performance ◽

Performance Scale ◽

Over Time

12095 Background: There are numerous predictive cancer tools that focus on survival. However, no tools predict risk of low performance status or severe symptoms, which are important for patient decision-making and early integration of palliative care. The aim of this study was to develop and validate a model for all cancer types that predicts the risk for having low performance status and severe symptoms. Methods: A retrospective, population-based, predictive study using linked administrative data from cancer patients from 2008-2015 in Ontario, Canada. Patients were randomly selected for model derivation (60%) and validation (40%). The derivation cohort was used to develop a multivariable logistic regression model to predict the risk of having the reported outcomes in the subsequent 6 months. Model performance was assessed using discrimination and calibration plots. The main outcome was low performance status using the Palliative Performance Scale. Secondary outcomes included severe pain, dyspnea, well-being, and depression using the Edmonton Symptom Assessment System. Outcomes were recalculated after each of 4 annual survivor marks. Results: We identified 255,494 cancer patients (57% female; median age of 64; common cancers were breast (24%) and lung (13%)). At diagnosis, the risk of having low performance status, severe pain, well-being, dyspnea, and depression in 6-months is 1%, 3%, 6%, 13% and 4%, respectively for the reference case (i.e. male, lung cancer, stage I, no symptoms). Generally these covariates increased the outcome risk by > 10% across all models: obstructive lung disease, dementia, diabetes; radiation treatment; hospital admission; high pain; depression; Palliative Performance Scale score of 60-10; issues with appetite; or homecare. Model discrimination was high across all models. Conclusions: The model accurately predicted changing cancer risk for low performance status and severe symptoms over time. Providing accurate predictions of future performance status and symptom severity can support decision-making and earlier initiation of palliative care, even alongside disease modifying therapies.

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Use of red blood cell transfusions in terminally ill cancer patients admitted to a palliative care unit

Journal of Pain and Symptom Management ◽

10.1016/0885-3924(96)00044-9 ◽

1996 ◽

Vol 12 (1) ◽

pp. 18-22 ◽

Cited By ~ 50

Author(s):

Massimo Monti ◽

Lucia Castellani ◽

Aurelia Berlusconi ◽

Ettore Cunietti

Keyword(s):

Palliative Care ◽

Blood Cell ◽

Cancer Patients ◽

Red Blood Cell ◽

Terminally Ill ◽

Palliative Care Unit ◽

Terminally Ill Cancer Patients ◽

Red Blood Cell Transfusions

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Number of Unused Medications at the Time of Last Admission: A Prospective Observational Study in a Single Palliative Care Unit

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909118784004 ◽

2018 ◽

Vol 35 (12) ◽

pp. 1498-1504

Author(s):

Takahito Omae ◽

Nobuyuki Yotani ◽

Akihiro Sakashita ◽

Yoshiyuki Kizawa

Keyword(s):

Palliative Care ◽

Observational Study ◽

Anticancer Drugs ◽

Prospective Observational Study ◽

Low Cost ◽

Palliative Care Unit ◽

Opioid Use ◽

Patients With Cancer ◽

Unused Medications ◽

The Cost

Background: Unused medications (UM) are an important issue, with the waste associated with UM a burden to the health-care system. The aims of this study were to clarify the amount and costs of UM in patients with advanced cancer at the time of their last admission to a palliative care unit and to explore the factors contributing to the cost of UM and how patients dealt with UM. Methods: A prospective observational study was conducted in single palliative care unit. Unused medications were classified into 6 categories and the number and cost of UM by category calculated per patient. Patients were classified into 2 cost groups (high and low) based on the total cost of UM, and the number and cost of UM by category were compared between these 2 groups. Results: Of 194 consecutive hospitalized patients, data were analyzed for 90. The mean number and cost of UM per patient was 440 and US$301, respectively. Opioids accounted for 47% of the cost of UM. Comparing costs by UM category, the proportion of opioids (51% vs 21%; P < .0001) and oral anticancer drugs (14% vs 3%; P = .02) was higher in the high- than in the low-cost group. Conclusion: Based on the results of the present study, the estimated annual waste cost of UM for patients with cancer who died in Japan was approximately US$110 million. Interventions to educate patients regarding UM and to eliminate barriers to opioid use may help reduce the cost of UM, particularly opioids and anticancer drugs.

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Frequency of Symptom Distress and Poor Prognostic Indicators in Palliative Cancer Patients Admitted to a Tertiary Palliative Care Unit, Hospices, and Acute Care Hospitals

Journal of Palliative Care ◽

10.1177/082585970001600304 ◽

2000 ◽

Vol 16 (3) ◽

pp. 16-21 ◽

Cited By ~ 62

Author(s):

Eduardo Bruera ◽

Catherine Neumann ◽

Carleen Brenneis ◽

Hue Quan

Keyword(s):

Palliative Care ◽

Cancer Patients ◽

Acute Care ◽

Acute Care Hospitals ◽

Symptom Distress ◽

Palliative Care Unit ◽

Prognostic Indicators

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Utilization of antineoplastic therapy (ANT) in advanced cancer patients admitted to an acute palliative care unit (APCU) at a comprehensive cancer center

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.9590 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 9590-9590

Author(s):

D. Hui ◽

E. Bruera ◽

Z. Li ◽

J. L. Palmer ◽

M. de la Cruz ◽

...

Keyword(s):

Palliative Care ◽

Regression Analysis ◽

Cancer Patients ◽

Univariate Analysis ◽

Palliative Care Unit ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Targeted Agents ◽

Cox Regression Analysis ◽

Younger Age

9590 Background: Cancer patients admitted to a palliative care unit generally have a poor prognosis. The role of ANT (chemotherapy and targeted agents) in these patients is unclear. We examined the frequency, trends, factors and survival associated with ANT use in hospitalized patients who required an APCU stay. Methods: All patients admitted to APCU between September 1, 2003 and August 31, 2008 were included. Demographics, cancer diagnosis and ANTs utilization from day of hospitalization to discharge, and survival information were retrieved retrospectively. Results: 2604 cancer patients had the following characteristics: median age 59 (range 18–101), male 51%, hematologic malignancy 11%, median hospital stay 11 (Q1-Q3 8–17) days, median APCU stay 7 (Q1-Q3 4–10) days and median survival 22 days. During hospitalization, 393 patients (15%) received ANTs, including chemotherapy (N=297, 11%) and targeted therapy (N=155, 6%). No significant change in frequency of ANTs was detected over the 5 year period. Multivariate logistic regression analysis ( Table ) revealed that younger age, cancer primaries and longer admissions were associated with ANT use. Patients with hematologic malignancies received more chemotherapy (38% vs. 8%, p<0.001) and targeted agents (18% vs. 4%, p<0.001) compared to patients with solid tumors. ANT use was associated with longer overall survival in univariate analysis (median 25 days vs. 21 days, p=0.001); however, this was no longer significant in multivariate Cox regression analysis. Conclusions: The use of ANT during hospitalization that included an APCU stay was limited to a highly selected group of patients, and did not increase overtime. ANT use was associated with younger age, specific cancer primaries, longer admissions, and no significant improvement in survival. The APCU at our cancer center facilitates simultaneous care where patients access palliative care while on ANT. [Table: see text] No significant financial relationships to disclose.

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