The Transplant Palliative Care Clinic: An early palliative care model for patients in a transplant program

2016 ◽  
Vol 30 (12) ◽  
pp. 1591-1596 ◽  
Author(s):  
Kirsten Wentlandt ◽  
Angela Dall'Osto ◽  
Nicole Freeman ◽  
Lisa W. Le ◽  
Ebru Kaya ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Model ◽  
Care Clinic ◽  
Early Palliative Care ◽  
Transplant Program

ANALYSIS OF FACTORS ASSOCIATED WITH LOSS OF FOLLOW UP AFTER INITIAL CONSULTATION AMONG THE PATIENTS ATTENDING THE PALLIATIVE CARE CLINIC IN A TERTIARY CARE HOSPITAL OF RURAL AREA OF THE WESTERN INDIA-AN OBSERVATIONAL STUDY.

2021 ◽  
pp. 29-30
Author(s):  
Namrata Donga ◽  
Sanket H Mehta ◽  
Dinesh Kumar ◽  
Alpa Patel ◽  
Rekha Macwan
Keyword(s):  
Palliative Care ◽  
Tertiary Care ◽  
Western India ◽  
Care Hospital ◽  
Early Referral ◽  
Care Clinic ◽  
Early Palliative Care ◽  
Ethical Committee Approval ◽  
Improve Compliance

Aim: To determine factors responsible for loss of follow up and thereby to improve compliance and adherence to treatment in a palliative care unit. Methods: Among the data of patients maintained in our department, we found 81 patients out of 1200 OPD visits who didn't turn up for follow up after the rst outpatient department (O.P.D) visit in the study period [July 2017-June 2018] . After taking the institutional ethical committee approval we did telephonic interview of those patients and/or their relatives, took their consent to participate after explaining the study in brief. We noted the reason of not coming for follow up in our questionnaire. Out of 81, 61 patients could be contacted on phone. Results: Major reason for loss of follow up was death after the rst visit (n=31). 7 patients had started alternate medicine. Factors like exhaustion due to prolong treatment and difculty in bringing patients were noted in 3 patients and 1 patient respectively. Other factors like lack of palliative care awareness, nancial incapability, or no benet from treatment were not found in any of the patient. Conclusion: Death after the rst visit was leading cause for loss of follow up. Majority of the deaths were within one month of the visit. Early referral and early palliative care interventions of those could have helped us to serve those patients better.

Oncology care model: Early palliative care experiences and outcomes.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 37-37 ◽  
Author(s):  
Pamela Spain ◽  
Nathan West ◽  
Stephanie Teixeira-Poit ◽  
Elizabeth Schaefer ◽  
Kerry Ketler
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
End Of Life ◽  
Shared Decision Making ◽  
Life Quality ◽  
Risk Scores ◽  
Shared Decision ◽  
Care Model ◽  
Early Palliative Care ◽  
Oncology Care

37 Background: Through the Oncology Care Model (OCM), the Center for Medicare & Medicaid Innovation at the Centers for Medicare & Medicaid Services aims to improve the effectiveness and efficiency of cancer care. OCM practices have committed to provide enhanced services to Medicare beneficiaries, including palliative care designed to optimize quality of life. This study examines if OCM practices engaging in early palliative care discussions have timely hospice referrals as well a lower aggressive end-of-life care and Medicare costs. Methods: During site visits to 30 OCM practices, we asked was How and when is palliative care introduced to patients? We used Medicare claims data to stratify the 30 practices into high or low performers based on 3 end-of-life quality measures scores. Next, we examined their scores on Cancer CAHPS shared decision making and Medicare expenditures, as well as what staff reported about the use of palliative care during site visits. Claims and CAHPS data encompass the first 6 months of OCM, July-December 2016. Site visits were conducted February - May 2017. Results: Patient risk scores were equal among practice groups. High Performers said: “Palliative care is introduced right off the bat. We provide information on hospice and palliative care so it’s not a word they find with end of life only. It’s a difficult conversation but you have to put it out there. As part of patient education, we say the differences between palliative care and hospice. Low Performers said: “Palliative care is introduced on a case by case basis. To transfer to an inpatient hospice, now you have to be on your last breath. Programs that get cut because they are not integral to the patients’ acute issues include palliative care. If hospice comes up, I pull palliative care at that point.” Conclusions: Early OCM results support growing evidence that palliative care shared decision making discussions are most beneficial near the time of cancer diagnosis. [Table: see text]

Early palliative care interventions in patients with hematologic malignancies prior to hematopoietic cell transplantation.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21634-e21634 ◽  
Author(s):  
M.Ahsan Alamgir ◽  
Sijin Wen ◽  
Michael D. Craig ◽  
Sandra L. Pedraza
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Cell Transplantation ◽  
Sleep Problems ◽  
Well Being ◽  
Categorical Variables ◽  
Care Clinic ◽  
Early Palliative Care ◽  
Edmonton Symptom Assessment Scale ◽  
The Impact

e21634 Background: Early palliative care (EPC) interventions have been endorsed by multiple medical societies, mostly for solid tumors but not for hematological malignancies. Patients undergoing hematopoietic stem cell transplantation (HSCT) suffer significant physical and emotional distress affecting negatively their quality of life (QOL). They also receive more aggressive end-of-life interventions than other cancer patients. Few studies have shown the impact of EPC in the pre-transplant phase on post transplant morbidity and mortality. Methods: 53 patients undergoing HSCT were evaluated on the supportive care clinic for symptom and needs assessment using the Edmonton symptom assessment scale (ESAS) to evaluate symptom burden prior to transplant. Consecutive palliative care visits were offered to patients. We also evaluated whether the supportive care clinic (SCC) visits made a difference on hospitalization rate and mortality comparing this group with 108 patient who did not undergo evaluation. Kaplan-Meier method and log-rank test were used in the survival analysis and Fisher’s exact test was used in the data analysis for categorical variables. Results: The most common symptoms reported by patients included: fatigue (4.4), sleep problems (3.7), pain (2.8), anxiety (2.8), well-being (2.7), and drowsiness (2.3). 26% (14) of the patients were followed in the SCC at 3 months. The most common symptoms at that time included fatigue (5.1), pain (4), drowsiness (3.6), sleep problems (3.1), well-being (2.9), and appetite (2.4). Overall mortality for the whole group was 24%. 28% for the palliative care group and 21% for the control group. Odds Ratio for mortality at 3 and 6 months were not significantly different between groups. Differences in hospital admissions were also not statistically significant. Conclusions: EPC in HSCT patients is feasible and may help with symptom detection and control. No effect on mortality or hospital admission rates was found on this study on patients referred for EPC interventions. Prospective studies are needed to clearly define the role of EPC in HSCT patients.

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