Impact of a dedicated supportive care center telephone triaging program (SCCTP) for patients with advanced cancer.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 54-54
Author(s):  
Lindsey E Pimentel ◽  
Sriram Yennurajalingam ◽  
Gary B. Chisholm ◽  
Tonya Edwards ◽  
Maria Guerra-Sanchez ◽  
...  
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Symptom Management ◽  
Care Center ◽  
Assessment Scale ◽  
Cancer Type ◽  
Advanced Cancer Patients ◽  
At Home

54 Background: Due to high symptom burden in advanced cancer patients, ongoing symptom management for outpatient palliative care patients is vital. More patients are receiving outpatient care; Yet, most palliative care patients receive less than 2 follow ups. Nurse telephone care can improve quality of life in these patients. Our aim was to determine frequency and care provided by Supportive Care Center Telephone Program (SCCTP) in advanced cancer patients. Methods: 400 consecutive patients who utilized palliative care service, 200 from outpatient Supportive Care Center (SCC) and 200 from inpatient Palliative Care (IPC), were followed for 6 months starting 3/2012 to examine call frequency and reason and outcomes including pain and other symptoms [Edmonton Symptom Assessment Scale (ESAS) and Memorial Delirium Assessment Scale (MDAS)] associated with utilization of SCCTP. We also examined the effect of SCCTP interventions on pain, ESAS and counseling needs. Results: 375 patients were evaluable. Median age 59 years, 53% female, 70% white. Most frequent cancer type were gastrointestinal (20%, p < 0.0001) for IPC and thoracic (23%, p <0.0001) for SCC. SCC patients had higher prevalence of CAGE positivity (28% SCC vs 11% IPC, p <0.0001), ESAS SDS(p=0.0134), depression(p=0.0009), anxiety(p=0.0097) and sleep(p=0.0015); MDAS scores were significantly higher in IPC (p<0.0001).115/400 patients (29%) utilized SCCTP. 96/115 outpatients (83%) used the SCCTP vs 19/115 IPC (17%). Common reasons for calls were pain (24%), pain medication refills (24%) and counseling (12%). Of 115 phone calls, 340 recommendations were made; 43% (145/340) were regarding care at home; 56% of these recommendations were regarding opioids. Patients who utilized SCCTP had worse pain(p=0.0059), fatigue(p=0.0448), depression(p=0.0410), FWB(p=0.0149) and better MDAS scores(p=0.0138) compared to non-utilizers. Conclusions: There was more frequent SCCTP use by outpatients than inpatients. Most common reason for utilization was pain control. Frequently, recommendations were made to continue symptom management at home. Patients who utilized SCCTP had worse pain, fatigue, depression, well-being scores and better delirium scores.

Effect of early palliative care on depression and survival in patients with advanced cancer.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 5-5 ◽  
Author(s):  
Anna Tekla Prescott ◽  
Jay Hull ◽  
J Nicholas Dionne-Odom ◽  
Kathleen Lyons ◽  
Tor Tosteson ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Mortality Risk ◽  
Cancer Type ◽  
Advanced Cancer Patients ◽  
Intervention Effect ◽  
Depressed Patients ◽  
Combining Data ◽  
Clinically Depressed

5 Background: We previously demonstrated improved depression and survival in advanced cancer patients participating in two palliative care (PC) RCTs: ENABLE II (EII; N=322) compared intervention vs. usual care, and ENABLE III (EIII; N=207) compared immediate vs. delayed intervention. The interventions were identical, except in EIII, the intervention included support for family caregivers and the delayed group began the intervention 12 weeks after enrollment. Both EII and EIII included an in-person PC consultation, weekly phone sessions facilitated by a nurse coach, and monthly follow-up calls. The Center for Epidemiologic Studies-Depression (CES-D) scale was collected at baseline and every 6 weeks until death or study completion. Our aim was to examine the moderating effects of baseline depression on the intervention effect and on survival outcomes in both RCTs. Methods: After combining data from the two RCTs the sample consisted of 529 patients. We conducted Cox proportional hazard analyses to examine the effect of the intervention (as a time-varying covariate) and baseline depression scores on subsequent survival. Results: The intervention significantly reduced mortality risk in this sample (Hazard Ratio [HR]= 0.78, CI: 0.63-0.98, p=.029). Adding baseline CES-D scores and the interaction of the intervention and CES-D scores as predictor variables yielded a significant interaction (HR= 0.97, p =.035) that remained after controlling for cancer type. Following this analysis, patients were classified as clinically depressed (baseline CES-D 16) or not, and Cox analyses were conducted using the intervention as the sole predictor within each depression group. Receiving the intervention significantly reduced mortality risk among clinically depressed patients (HR = 0.65, CI: 0.44-0.95, p =.029), but not among non-depressed patients (HR = 0.89, CI: 0.65-1.21, p >.45). Conclusions: The ENABLE intervention improved survival in this combined sample of advanced cancer patients. The intervention effect on survival was moderated by baseline depression levels, such that patients who were depressed at baseline and received the intervention had a longer survival compared with non-depressed intervention patients.

A home-based palliative care pilot program for patients with advanced cancer.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 164-164
Author(s):  
Rae Seitz ◽  
Charles F. Miller ◽  
Michael Duick ◽  
Robert Eubanks
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Symptom Management ◽  
Pilot Program ◽  
Care Services ◽  
Home Based ◽  
Palliative Care Services ◽  
Acute Care Services

164 Background: Advanced cancer care often lacks a comprehensive approach; in Hawaii most oncology practices do not have access to palliative care teams. This causes high use of acute care services and suboptimal symptom management. Hawaii Medical Service Association (HMSA) created a pilot program called Supportive Care in which home-based palliative care services are offered to members with advanced cancer with goals of improved clinical outcomes and decrease utilization of acute care services Methods: Patients must have stage III or IV malignancy and ECOG PS of 2 or greater. Palliative care services are provided by Medicare-certified hospice agencies, with interdisciplinary teams, 24/7 on-call capacity, and expertise in symptom management. Hospice agencies are paid by HMSA to provide intermittent home visits. DME and pharmaceuticals. Care is coordinated with the patient's treating oncologist and other care providers. Each patient may receive 90 days of Supportive Care services in a 12 month period. Services are suspended during hospitalization or placement in a skilled nursing facility. Results: Patients enrolled in this program utilized hospital services significantly less than other Medicare Beneficiaries during the end-of-life period, suggesting that complex medical and psychosocial needs can be met in the home environment. The table compares findings from cancer patients enrolled in Supportive Care during 2014 with the most recent data available from The Dartmouth Atlas of Health Care. Conclusions: Multiple studies show improved quality of life for cancer patients receiving palliative care. Supportive Care resulted in improved clinical outcomes. Anecdotal feedback indicates high satisfaction among patients, families, and providers. Research to collect data and quantify satisfaction continues. [Table: see text]

Acceptance of illness of advanced cancer patients in palliative care center in Kuwait.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e21501-e21501
Author(s):  
Khalid Al Saleh ◽  
Najla Soliman ◽  
Maha Abdullah ◽  
Fatima Abdelshokoor ◽  
Huda Sheab
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Care Center ◽  
Advanced Cancer Patients ◽  
Acceptance Of Illness

scholarly journals Late referrals to home palliative care service affecting death at home in advanced cancer patients in Japan: a nationwide survey

2011 ◽  
Vol 22 (9) ◽  
pp. 2113-2120 ◽  
Author(s):  
S. Fukui ◽  
J. Fujita ◽  
M. Tsujimura ◽  
Y. Sumikawa ◽  
Yayoi Hayashi ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Care Service ◽  
Palliative Care Service ◽  
Nationwide Survey ◽  
Advanced Cancer Patients ◽  
At Home

scholarly journals Challenges of Managing Advanced Cancer Patients through Phone Triaging at an Outpatient Supportive Care Clinic: A Case Series of Palliative Care Patients

2012 ◽  
Vol 6 ◽  
pp. PCRT.S10733
Author(s):  
Lindsey E. Pimentel ◽  
Sriram Yennurajalingam ◽  
Elizabeth D. Brown ◽  
Debra K. Castro
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Advanced Cancer ◽  
Case Reports ◽  
Care Center ◽  
Case Series ◽  
Cancer Center ◽  
Advanced Cancer Patients ◽  
Care Clinic ◽  
Outpatient Supportive Care

Palliative care strives to improve the quality of life for patients and their families by impeccable assessment and management using an interdisciplinary approach. However, patients with cancer-related pain and other symptoms tend to be undertreated because of limited follow-up visits due to late referrals and logistics. Thus, patients who present to the outpatient Supportive Care Center at The University of Texas MD Anderson Cancer Center often experience severe physical and psychological symptoms. The two case reports presented highlight the challenges of managing distressed patients with advanced cancer in the outpatient setting. These descriptions focus on addressing patient needs over the phone to enhance the care patients receive at the Supportive Care Center. Future prospective studies are needed to measure the effectiveness of using phone triaging in conjunction with standard outpatient palliative care.

Delirium assessed by Memorial Delirium Assessment Scale in advanced cancer patients admitted to an acute palliative/supportive care unit

2017 ◽  
Vol 33 (7) ◽  
pp. 1303-1308 ◽  
Author(s):  
Sebastiano Mercadante ◽  
Claudio Adile ◽  
Patrizia Ferrera ◽  
Andrea Cortegiani ◽  
Alessandra Casuccio
Keyword(s):  
Supportive Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Assessment Scale ◽  
Advanced Cancer Patients ◽  
Delirium Assessment

A palliative radiation oncology consult service’s impact on care of advanced cancer patients with symptomatic bone metastases.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 110-110
Author(s):  
Sanders Chang ◽  
Cardinale B. Smith ◽  
R. Sean Morrison ◽  
Kenneth Rosenzweig ◽  
Kavita Vyas Dharmarajan
Keyword(s):  
Palliative Care ◽  
Bone Metastases ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Radiation Oncology ◽  
Cancer Type ◽  
Advanced Cancer Patients ◽  
Palliative Radiation ◽  
The Impact ◽  
Pain Improvement

110 Background: Single-fraction and ≤ 5 fraction radiation treatment (SF-RT and Hypo-RT, respectively) is underutilized despite strong evidence regarding its efficacy in symptom management. Established in 2013, the Palliative Radiation Oncology Consult Service (PROC) is a specialty service designed to provide individualized, efficient treatment for advanced cancer patients by a radiation oncology team with a dedicated palliative care focus. We assessed the impact of this new model of care on use of SF-RT, hypo-RT, pain improvement, palliative care utilization, and hospitalization among patients treated with palliative radiation (PRT) for painful bone metastases. Methods: We searched electronic charts of advanced cancer patients who had PRT for symptomatic bone mets from Dec 2010 to April 2015, extracting PRT details, demographics, cancer type, pain pre- and 1 month post-PRT, comorbidities (summarized using Charlson comorbidity index [CCI]), palliative care consults, and hospitalization. Comparisons were made before and after PROC using chi-square or t-tests. Multivariable logistic regression estimated the likelihood of SF-RT or hypo-RT, controlling for age, gender, cancer type, treatment site, and CCI. Results: We identified 334 patients, described in the table below. Patients were more likely to have SF-RT (OR 2.2, 95% CI [1.2-3.8], p = 0.007), or hypo-RT (OR 3.0, 95% CI [1.8-4.7], p < 0.001) after establishment of PROC. Conclusions: Establishment of a PROC service nearly doubled utilization of SF-RT and hypo-RT while maintaining pain improvement, and was associated with an increased use of palliative care consult services, decreased inpatient PRT use, and decreased length of stay. A dedicated service combining palliative care principles and radiation oncology improved quality of palliative cancer care. [Table: see text]

Exploring the preferences for place of death among cancer patients and their family caregivers.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 40-40 ◽  
Author(s):  
Marieberta Vidal
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Place Of Death ◽  
Hospital Death ◽  
Advanced Cancer Patients ◽  
Home Death ◽  
Significant Difference ◽  
The Uk ◽  
At Home

40 Background: Understanding the preferred place of death (POD) for advanced cancer patients (Pts) is very important when they are approaching the end of life. Meeting the preferences of Pts is considered an important palliative care (PC) outcome. Prior studies reported that more than 80% of Pts with terminally ill cancer prefer to die at home. In many countries such as the UK, Italy, Greece, South Korea and Japan home deaths have been falling, but in some states of the US and Canada there are indications of a reversal of trends. Dying at home may be more difficult for Pts in severe physical and psychosocial distress, or when there are social or financial difficulties. The purpose of this study was to determine POD preference among PC Pts in the outpatient center (OC) and the palliative care unit (PCU). Methods: A sectional anonymous questionnaire was administered to advanced cancer Pts and caregivers (PCU patients and OC) between August 2012 and September 2014. PCU Pts responded when there was no delirium and the primary caregiver responded when the patient was unable to respond. In the case of outpatients dyads (patient and caregiver) were assessed. Results: Overall 141/216 (65%) preferred home death. PCU patients preferred home death less than outpatients. Patient and caregiver agreement regarding preferred place of death was 86% (p <0.001). The preferred POD was the same as one month ago for 82/99 (83%) PCU Pts and 111/116 (96%) outpatients, with significant difference between groups (p=0.002). Conclusions: Although home is the preferred POD in advanced cancer Pts, a substantial minority prefer hospital death or no difference. Patients admitted to the PCU have a higher preference for hospital death in comparison to the outpatients, likely reflecting more severe distress because they already tried home care. Pts and caregivers agree on POD in most cases. Personalized assessment of POD preference for both patient and caregiver is needed. [Table: see text]

Sign in / Sign up

Export Citation Format

Share Document