scholarly journals Palliative Care Needs of Patients With Cancer Living in the Community

2011 ◽  
Vol 7 (6) ◽  
pp. 382-388 ◽  
Author(s):  
Arif H. Kamal ◽  
Janet Bull ◽  
Dio Kavalieratos ◽  
Donald H. Taylor ◽  
William Downey ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advanced Cancer ◽  
Community Dwelling ◽  
Care Needs ◽  
Patients With Cancer ◽  
Palliative Care Needs

The authors describe the current palliative care needs of a population of community-dwelling patients with advanced cancer who are not yet ready for transition to hospice.

Palliative Referrals in Advanced Cancer Patients: Utilizing the Supportive and Palliative Care Indicators Tool and Rothman Index

2021 ◽  
pp. 104990912110178
Author(s):  
Abigail Sy Chan ◽  
Amit Rout ◽  
Christopher R. D.’Adamo ◽  
Irina Lev ◽  
Amy Yu ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Length Of Hospital Stay ◽  
Inpatient Setting ◽  
Advanced Cancer Patients ◽  
Care Needs ◽  
Early Palliative Care ◽  
Code Status ◽  
Palliative Care Needs

Background: Timely identification of palliative care needs can reduce hospitalizations and improve quality of life. The Supportive & Palliative Care Indicators Tool (SPICT) identifies patients with advanced medical conditions who may need special care planning. The Rothman Index (RI) detects patients at high risk of acutely decompensating in the inpatient setting. SPICT and RI among cancer patients were utilized in this study to evaluate their potential roles in palliative care referrals. Methods: Advanced cancer patients admitted to an institution in Baltimore, Maryland in 2019 were retrospectively reviewed. Patient demographics, length of hospital stay (LOS), palliative care referrals, RI scores, and SPICT scores were obtained. Patients were divided into SPICT positive or negative and RI > 60 or RI < 60.Unpaired t-tests and chi-square tests were utilized to determine the associations between SPICT and RI and early palliative care needs and mortality. Results: 227 patients were included, with a mean age of 68 years, 63% Black, 59% female, with the majority having lung and GI malignancies. Sixty percent were SPICT +, 21% had RI < 60. SPICT + patients were more likely to have RI < 60 (p = 0.001). SPICT + and RI < 60 patients were more likely to have longer LOS, change in code status, more palliative/hospice referrals, and increased mortality (p <0.05). Conclusions: SPICT and RI are valuable tools in predicting mortality and palliative/hospice care referrals. These can also be utilized to initiate early palliative and goals of care discussions in patients with advanced cancer.

scholarly journals Palliative Care Needs of Advanced Cancer Patients in the Emergency Department (S767)

2018 ◽  
Vol 55 (2) ◽  
pp. 693
Author(s):  
Isabelle Marcelin ◽  
Caroline McNaughton ◽  
Nicole Tang ◽  
Jeffrey Caterino ◽  
Corita Grudzen
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Advanced Cancer Patients ◽  
Care Needs ◽  
Palliative Care Needs

scholarly journals E10-B Palliative Care Needs at Different Phases in the Illness Trajectory: A Survey Study in Patients with Cancer

2016 ◽  
Vol 52 (6) ◽  
pp. e45
Author(s):  
Kim Beernaert ◽  
Koen Pardon ◽  
Lieve Van den Block ◽  
Dirk Devroey ◽  
Martine De Laat ◽  
...  
Keyword(s):  
Palliative Care ◽  
Survey Study ◽  
Care Needs ◽  
Illness Trajectory ◽  
Patients With Cancer ◽  
Palliative Care Needs

Pulmonary referrals to specialist palliative medicine: a survey

2021 ◽  
pp. bmjspcare-2021-003386
Author(s):  
Michael Bonares ◽  
Kenneth Mah ◽  
David Christiansen ◽  
John Granton ◽  
Andrea Weiss ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Chronic Respiratory Disease ◽  
Life Care ◽  
Care Needs ◽  
Patients With Cancer ◽  
Referral Criteria ◽  
Referral Practices ◽  
Palliative Care Needs

ObjectivesPatients with chronic respiratory disease have significant palliative care needs, but low utilisation of specialist palliative care (SPC) services. Decreased access to SPC results in unmet palliative care needs among this patient population. We sought to determine the referral practices to SPC among respirologists in Canada.MethodsRespirologists across Canada were invited to participate in a survey about their referral practices to SPC. Associations between referral practices and demographic, professional and attitudinal factors were analysed using regression analyses.ResultsThe response rate was 64.7% (438/677). Fifty-nine per cent of respondents believed that their patients have negative perceptions of palliative care and 39% were more likely to refer to SPC earlier if it was renamed supportive care. While only 2.7% never referred to SPC, referral was late in 52.6% of referring physicians. Lower frequency of referral was associated with equating palliative care to end-of-life care (p<0.001), male sex of respirologist (p=0.019), not knowing referral criteria of SPC services (p=0.015) and agreement that SPC services prioritise patients with cancer (p=0.025); higher referral frequency was associated with satisfaction with SPC services (p=0.001). Late referral was associated with equating palliative care to end-of-life care (p<0.001) and agreement that SPC services prioritise patients with cancer (p=0.013).ConclusionsPossible barriers to respirologists’ timely SPC referral include misperceptions about palliative care, lack of awareness of referral criteria and the belief that SPC services prioritise patients with cancer. Future studies should confirm these barriers and evaluate the effectiveness of strategies to overcome them.

scholarly journals 1-2-3 Project: A Quality Improvement Initiative to Normalize and Systematize Palliative Care for All Patients With Cancer in the Outpatient Clinic Setting

2018 ◽  
Vol 14 (12) ◽  
pp. e775-e785 ◽  
Author(s):  
Anjali V. Desai ◽  
Virginia M. Klimek ◽  
Kimberly Chow ◽  
Andrew S. Epstein ◽  
Camila Bernal ◽  
...  
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Outpatient Clinic ◽  
Core Values ◽  
Newly Diagnosed ◽  
Care Needs ◽  
Patients With Cancer ◽  
Palliative Care Consultation ◽  
Care Consultation ◽  
Palliative Care Needs

Background: Prior work to integrate early palliative care in oncology has focused on patients with advanced cancer and primarily on palliative care consultation. We developed this outpatient clinic initiative for newly diagnosed patients at any stage, emphasizing primary (nonspecialist) palliative care by oncology teams, with enhanced access to palliative care specialists. Methods: We piloted the project in two medical oncology specialty clinics (for patients with myelodysplastic syndrome and GI cancer, respectively) to establish feasibility. On a visit-based schedule, patients systematically reported symptoms, information/decision-making preferences, and illness understanding. They also participated in discussions of their core values with their oncology nurse. Oncology teams were first responders to palliative care needs, whereas specialists were available for clinician support and direct patient consultation. Results: All 58 eligible patients were enrolled. In both clinics, patient self-reports documented a heavy symptom burden. Information/decision-making preferences and illness understanding levels varied across patients. Patients prepared new advance directives. Oncology nurses documented discussions of core values. Requests for palliative care consultation decreased over time as oncology teams embraced their primary palliative care role with coaching from the specialists. Clinic workflow and patient volume were maintained. Conclusion: Our pilot experience suggests that in outpatient oncology clinics, a structured, scheduled, and systematic approach is feasible to deliver palliative care to newly diagnosed patients with cancer at any stage and throughout their illness trajectory. This novel approach identified important, actionable palliative care needs, relying primarily on oncology teams to respond to these needs, while enhancing access to palliative care specialist input. Expansion to additional clinics will allow evaluation of scalability and generalizability, along with measurement of a broader range of important outcomes.

Health professionals' views on services for patients with cancer-related palliative care needs

2006 ◽  
Vol 13 (1) ◽  
pp. 15-21
Author(s):  
Margaret Thomson ◽  
Paula Hourston ◽  
Jo Ladley ◽  
Leigh Findlay ◽  
Aileen Kelly
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Care Needs ◽  
Patients With Cancer ◽  
Palliative Care Needs

Palliative referrals in advanced cancer patients: Utilizing the Supportive and Palliative Care Indicators Tool and Rothman Index.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12102-12102
Author(s):  
Abigail Sy Chan ◽  
Amit Rout ◽  
Irina Lev ◽  
Amy Yu ◽  
Chris D'Adamo ◽  
...  
Keyword(s):  
Palliative Care ◽  
Hospital Stay ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Hospice Care ◽  
Inpatient Setting ◽  
Care Needs ◽  
Clinical Indicators ◽  
Code Status ◽  
Palliative Care Needs

12102 Backgroun1d: Timely identification of palliative care needs have the ability to reduce hospitalizations and improve QOL. The Supportive & Palliative Care Indicators Tool (SPICT) is used to identify patients with advanced stage medical conditions who may need special care planning. The Rothman Index (RI) detects patients at high risk of acutely decompensating in the inpatient setting and has been validated to assess 24-hour mortality risk. We used SPICT and RI in cancer patients admitted to the hospital and evaluated their roles in recognizing early palliative care needs and 6-month mortality. Methods: Advanced/metastatic cancer patients admitted to our institution from Jan 1, 2019 to June 30, 2019 were retrospectively reviewed. Patient demographics, length of hospital stay (LOS), comorbidities, palliative/hospice care referrals, vital status, initial RI score, and computed SPICT scores were obtained. Worse clinical indicators were defined as SPICT positive if it met > 2 clinical indicators or RI < 60. Univariate and bivariate analyses were performed. Results: A total of 227 patients were included, mean age 68, 34% Caucasians, 63% Blacks, 59% female, median comorbidities of 3, with majority having lung and GI malignancies. A total of 137 (60%) were SPICT +, 47 (21%) had RI < 60, and 38 (17%) concurrent SPICT + and RI < 60. SPICT + patients were more likely to have longer hospital stay, change in code status, more palliative/hospice referrals, and increased mortality. Those with RI < 60 had similar results (Table). SPICT + patients are more likely to have RI < 60 (p = 0.0013). Conclusions: SPICT and RI are valuable tools in predicting 6-month mortality and palliative/hospice care referrals. These can also be utilized to initiate early palliative and goals of care discussions in patients with advanced cancer. [Table: see text]

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