scholarly journals Palliative Radiotherapy with or without Additional Care by a Multidisciplinary Palliative Care Team: A Retrospective Comparison

ISRN Oncology ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Carsten Nieder ◽  
Kent Angelo ◽  
Astrid Dalhaug ◽  
Adam Pawinski ◽  
Gro Aandahl ◽  
...  
Keyword(s):  
Palliative Care ◽  
Performance Status ◽  
Symptom Control ◽  
Palliative Radiotherapy ◽  
Palliative Care Team ◽  
Care Team ◽  
Dose Fractionation ◽  
Poor Performance Status ◽  
Pattern Of Care ◽  
The Impact

Purpose. To analyze pattern of care and survival after palliative radiotherapy (RT) in patients managed exclusively by regular oncology staff or a multidisciplinary palliative care team (MPCT) in addition. Methods. Retrospective analysis of 522 RT courses. Comparison of Two Groups: MPCT versus none. Results. We analyzed 140 RT courses (27%) with MPCT care and 382 without it. The following statistically significant differences were observed: 33% of female patients had MPCT care versus only 23% of male patients and 37% of patients <65 years had MPCT care versus only 22% of older patients. MPCT patients were more likely to have poor performance status and liver metastases. In the MPCT group steroid and opioid use was significantly more common. Dose-fractionation regimens were similar. Median survival was significantly shorter in the MPCT group, 3.9 versus 6.9 months. In multivariate analysis, MPCT care was not associated with survival. Adjusted for confounders, MPCT care reduced the likelihood of incomplete RT by 33%, P>0.05. Conclusions. Patterns of referral and care differed, for example, regarding age and medication use. It seems possible that MPCT care reduces likelihood of incomplete RT. Therefore, the impact of MPCT care on symptom control should be investigated and objective referral criteria should be developed.

Hospital based palliative care teams improve the insight of cancer patients into their disease

2004 ◽  
Vol 18 (1) ◽  
pp. 46-52
Author(s):  
Barbara Jack ◽  
Valerie Hillier ◽  
Anne Williams ◽  
Jackie Oldham
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Assessment Tool ◽  
Symptom Control ◽  
Palliative Care Team ◽  
Care Team ◽  
Care Assessment ◽  
Palliative Care Teams ◽  
The Impact ◽  
Doctors And Nurses

It is reported that cancer patients want as much information as possible about their diagnosis and prognosis. This input regarding patients' insight into their disease is undoubtedly a major part of providing optimal palliative care. Despite this, there is little information regarding the impact of hospital based palliative care teams. An evaluation study comprising a nonequivalent control group design, using a quota sample, investigated 100 cancer patients who had been admitted to hospital for symptom control. Fifty patients received hospital palliative care team intervention compared with 50 patients receiving traditional care. Outcome was assessed using the Palliative Care Assessment tool (PACA) assessment tool on three occasions that measured the patients self-reported understanding of their illness. A supplementary qualitative approach that included 31 semistructured interviews with doctors and nurses to explore their perception of the impact of the palliative care team was also undertaken. The results indicated that cancer patients admitted to hospital for symptom control demonstrated an improvement in their insight to their diagnosis. Those patients who had the additional input of the palliative care team had a significantly greater improvement in their insight scores (reported by the doctors and nurses as being invaluable for the patients). Potential explanations are made for these results including enhanced communication skills of the palliative care team are explored.

Palliative medicine

2019 ◽  
pp. 547-556
Keyword(s):  
Palliative Care ◽  
Medical Students ◽  
Symptom Control ◽  
Occupational Therapists ◽  
Palliative Care Team ◽  
Care Team ◽  
Spiritual Needs ◽  
Patient Symptom ◽  
Inpatient Nursing ◽  
Medical Teams

The chapter underlines the importance of early involvement of the palliative care team to help patients to live better and longer. Palliative care is a multidisciplinary specialty and the role of community and inpatient nursing staff, physiotherapists, occupational therapists, psychologists, and the bereavement, chaplaincy, and medical teams are discussed. The chapter also covers where palliative care is delivered, which can be at home as well as in a hospice or a hospital. Advice is given on where and when medical students can learn the most from the palliative care team, from listening to one of the palliative care consultants take a history to observing the palliative care team prescribing anticipatory medications for the dying patient. Symptom control, including pain, nausea and vomiting, anorexia, constipation, diarrhoea, and breathlessness are also discussed. The chapter focuses not only on the patient and her/his psychological and spiritual needs but also on family members and carers who might also have their own needs. The chapter underlines the importance of communication skills in palliative care and how medical students should observe carefully in either the hospice or in hospital to learn from interactions that are difficult as well as the ones that go well.

Evaluating the impact of early versus late inpatient palliative care consultation for cancer patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6638-6638
Author(s):  
Brian Cassel ◽  
Patrick J. Coyne ◽  
Nevena Skoro ◽  
Kathleen Kerr ◽  
Egidio Del Fabbro
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Palliative Care Team ◽  
Care Team ◽  
Care Hospital ◽  
Palliative Care Consultation ◽  
Social Security Death Index ◽  
Hospital Deaths ◽  
Care Consultation ◽  
The Impact

6638 Background: Access to specialist palliative care (hospital-based or hospice) is a recognized measure of quality in cancer care. Most cancer centers do have palliative care consult services, although the availability of a comprehensive program that includes a palliative care unit and outpatient clinic (Hui 2010) is inconsistent. A simultaneous integrated model of palliative care that facilitates earlier access to a specialized palliative care team may improve clinical outcomes. Palliative care programs should measure the access, timing and impact of their clinical service. Methods: Hospital claims data were linked to Social Security Death Index (SSDI) data from the US Department of Commerce. 3,128 adult cancer patients died between January 2009 and July 2011 and had contact with our inpatient palliative care team in their last six months of life. We determined whether IPC earlier than 1 month prior to death had an impact on hospitalizations, in-hospital mortality and referral to hospice. Results: 27.5% of cancer decedents accessed IPC, median of 22 days before death. 13.2% were discharged to hospice, median of 13 days before death. Patients with IPC earlier than 1 month until death were more likely to have hospice and fewer in-hospital deaths but there was no association between early IPC and a 30-day mortality admission. Conclusions: Palliative care services are accessed by a minority of patients and typically in the last 2-3 weeks of life. Although in-hospital deaths were reduced by earlier palliative care consultation, 30 day mortality did not improve. Hospitals may need to implement other strategies including early integration of outpatient palliative care among cancer patients, to achieve an impact on 30-day mortality admissions. [Table: see text]

scholarly journals Palliative medicine in the intensive care unit: needs, delivery, quality

2021 ◽  
pp. bmjspcare-2020-002795
Author(s):  
Stephanie A Hill ◽  
Abdul Dawood ◽  
Elaine Boland ◽  
Hannah E Leahy ◽  
Fliss EM Murtagh
Keyword(s):  
Palliative Care ◽  
Intensive Care ◽  
Length Of Stay ◽  
Care Delivery ◽  
Multiorgan Failure ◽  
Symptom Control ◽  
Palliative Care Team ◽  
Care Team ◽  
Specialist Palliative Care ◽  
Treatment Limitation

Background15%–20% of critical care patients die during their hospital admission. This service evaluation assesses quality of palliative care in intensive care units (ICUs) compared with national standards.MethodsRetrospective review of records for all patients who died in four ICUs (irrespective of treatment limitation) between 1 June and 31 July 2019. Descriptive statistics reported for patient characteristics, length of stay, admission route, identification triggers and palliative care delivery.ResultsForty-five patients died, two records were untraced, thus N=43. The dying process was recognised in 88% (n=38). Among those where dying was recognised (N=35), 97% (34) had documented family discussion before death, 9% (3) were offered religious/spiritual support, 11% (4) had review of hydration/nutrition and 6% (2) had documented preferred place of death. Prescription of symptom control medications was complete in 71% (25) opioids, 34% (12) haloperidol, 54% (19) midazolam and 43% (15) hyoscine. Combining five triggers—length of stay >10 days prior to ICU admission 7% (3), multiorgan failure ≥3 systems 33% (14), stage IV malignancy 5% (2), post-cardiac arrest 23% (10) and intracerebral haemorrhage requiring mechanical ventilation 12% (5)—identified 60% (26) of patients. Referral to the palliative care team was seen in 14% (5), and 8% (3) had specialist palliative care team review.ConclusionsRecognition of dying was high but occurred close to death. Family discussions were frequent, but religious/spiritual needs, hydration/nutrition and anticipatory medications were less often considered. The ICUs delivered their own palliative care in conjunction with specialist palliative care input. Combining five triggers could increase identification of palliative care needs, but a larger study is needed.

The benefits of a hospital palliative care team

2019 ◽  
Vol 25 (7) ◽  
pp. 345-352
Author(s):  
Federica Sganga ◽  
Christian Barillaro ◽  
Andrea Tamburrano ◽  
Nicola Nicolotti ◽  
Andrea Cambieri ◽  
...  
Keyword(s):  
Palliative Care ◽  
Length Of Stay ◽  
Average Length ◽  
Severe Heart Failure ◽  
Palliative Care Team ◽  
Care Team ◽  
Severe Illness ◽  
Hospital Death ◽  
Hospital Outcome ◽  
The Impact

Aim: To investigate the association between a hospital palliative care unit assessment and hospital outcome. Methods: This was a prospective cohort study. Data were assessed from all patients treated and followed by the hospital palliative care team (HPCT) from November 2016 until December 2017. Results: The mean age of the 588 patients was 73.15±13.6 years. All of the patients included in the study were referred to palliative care. A large proportion of patients were affected by cancer, 69.7% (410), while 30.3% (178) were affected by an advanced chronic illness. The three most frequent cancers were: gastrointestinal (n=81, 19.8%), gynaecological (n=66, 16.1%) and lung (n=63, 15.4%); the three most frequent chronic advanced diseases were: advanced dementia (n=45, 25.3%), severe ischaemic/haemorrhagic stroke (n=36, 20.2%) and severe heart failure (n=25, 15.3%). The majority of patients were in clinical wards (n=476, 81.0%) and the average length of stay was 22.9 days. Hospital outcome trends were evaluated in terms of length of stay and number of deaths that occurred in the hospital. In particular, length of stay decreased from 25.8 days to 18.1 days, hospital death from 13 to 0 during the time that the HPCT assessed patients for an appropriate discharge. Conclusion: The HPCT is an effective means of managing patients affected by severe illness, reducing the number of deaths that occur within the hospital, long periods of hospitalisation and instances of readmission. However, further studies are required to fully assess the impact of an HPCT on hospital outcomes.

Hospital palliative care team survey of symptom control requirements of pancreatic cancer patients

2012 ◽  
Vol 2 (Suppl 1) ◽  
pp. A71.1-A71
Author(s):  
Sarah De Vos ◽  
Karen Badgery ◽  
Sophie Noble ◽  
Matthew Metcalfe ◽  
William Steward ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Palliative Care ◽  
Cancer Patients ◽  
Symptom Control ◽  
Palliative Care Team ◽  
Care Team
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