scholarly journals Identifying the Needs Based on the Patients’ Performance Status for Palliative Care Team: An Observational Study

2021 ◽  
Vol 0 ◽  
pp. 1-7
Author(s):  
Ryo Sakamoto ◽  
Atsuko Koyama
Keyword(s):  
Palliative Care ◽  
Family Support ◽  
Respiratory Symptoms ◽  
Performance Status ◽  
Gastrointestinal Symptoms ◽  
Palliative Care Team ◽  
Care Team ◽  
University Hospital ◽  
Nutrition Support ◽  
To Receive

Objectives: The study aim was to determine the association between patient performance status (PS) and the contents of a palliative care team (PCT) intervention. Identifying intervention requirements for differing PS may help to provide appropriate palliative care in under-resourced facilities. Materials and Methods: We collected data from medical records of inpatients (n = 496) admitted to PCT services at a centre for palliative care at Kindai University Hospital, Japan, from April 2017 to March 2019. We analysed the content of PCT activities according to each PS using Pearson’s Chi-square test. Results: The following PCT activities were provided in full regardless of PS: Gastrointestinal symptoms, depression, medical staff support, food and nutrition support and oral care. The following PCT responses were associated with PS: Pain, respiratory symptoms, fatigue, insomnia, anxiety, delirium, decision-making support, family support and rehabilitation. PS3 patients tended to receive those PCT interventions associated with PS, except for anxiety and fatigue. PS4 patients received PCT interventions for respiratory symptoms, delirium and family support. Patients with good PS (0–1) tended to receive PCT interventions for anxiety. Conclusion: This study demonstrated that there were different needs for different PS. The results may allow for efficient interventions even in facilities with limited resources.

scholarly journals Does a Hospital Palliative Care Team Have the Potential to Reduce the Cost of a Terminal Hospitalization? A Retrospective Case-control Study in a Czech Tertiary University Hospital

2021 ◽  
Author(s):  
Zuzana Kremenova ◽  
Jan Svancara ◽  
Petra Kralova ◽  
Martin Moravec ◽  
Katerina Hanouskova ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Case Control Study ◽  
Case Control ◽  
Palliative Care Team ◽  
Care Team ◽  
University Hospital ◽  
Insurance Company ◽  
Retrospective Case ◽  
Control Study

Abstract Background: More than 50% of patients worldwide die in hospitals. It is well known that end-of-life hospital care is costly.Our aims were to test whether the support of the palliative team can reduce end-of-life costs and to study the mechanisms of cost reduction.Methods: This was a one-centre descriptive retrospective case-control study. Big data from registries of routine visits were used for case-control matching. We included the expenses billed to the insurance company and added separately charged drugs and materials. We compared the groups over the duration of the terminal hospitalization, ICU days (ICU=intensive care unit), IV antibiotic use (IV=intravenous), MRI/CT scans (MRI/CR=magnetic resonance imaging/computed tomography), oncologic treatment in the last month of life, and documentation of the dying phase.We searched for all in-hospital cases who died in the university hospital in Prague with the support of the hospital palliative team from January 2019 to April 2020 and matched them with similar controls. The controls were matched according to age, sex, Charlson comorbidity index and diagnosis recorded on the death certificate.Results: We identified 213 dyads. The average daily costs were three times lower in the palliative group (4,392.4 CZK per day=171.3 EUR) than in the non-palliative group (13,992.8 CZK per day=545.8 EUR), and the difference was caused by the shorter time spent in the ICU (16% vs 33% of hospital days). This was probably due to better documentation of the dying phase in the medical records.Conclusions: To date, there are sparse hospital data available on the economic aspects of end-of-life care. We showed that the integration of the palliative care team in the dying phase can be cost saving. The evidence that hospital palliative care can save a substantial amount of money can be used to support the integration of palliative care in hospitals in middle- and low-income countries. A multicentre study with the same design is planned in the future to increase the strength of the results.

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.

Implementation of a palliative care team in an Austrian university hospital

2006 ◽  
Vol 14 (8) ◽  
pp. 795-801 ◽  
Author(s):  
Imke Strohscheer ◽  
Julijana Verebes ◽  
Hellmut Samonigg
Keyword(s):  
Palliative Care ◽  
Palliative Care Team ◽  
Care Team ◽  
University Hospital

Breathlessness and opioid therapy: A retrospective chart analysis in 2,958 patients.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 192-192
Author(s):  
Benjamin Gronwald ◽  
Michael Wolff ◽  
Jan Gaertner ◽  
Patric Bialas ◽  
Marcus Niewald ◽  
...  
Keyword(s):  
Palliative Care ◽  
Palliative Care Service ◽  
Opioid Therapy ◽  
Palliative Care Team ◽  
Care Team ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Prolonged Release ◽  
Common Symptom ◽  
Distressing Symptom

192 Background: Breathlessness is a common and distressing symptom, which increases in many diseases as they progress and is difficult to manage. It is widely accepted that opioids are safe and effective for treating dyspnea, although no single opioid has an authorization for the treatment of breathlessness. The aims of the study were to assess prevalence rates of breathlessness as well as the treatment approaches especially with respect to opioid therapy in all patients cared by a hospital palliative care team in a university hospital over a period of five years. Methods: A systematic review of all electronically available records of patients under palliative care service from April 2010 – April 2015 was performed. Results: Breathlessness was the third most common symptom in our patient group behind fatigue and pain. Furthermore it was classified as the utmost distressing symptom of all. Many patients suffering from breathlessness were opioid-naive before contact with our palliative care team. Many of these patients were put on prolonged-release opioids together with short-acting opioids (mucosal fentanyl) as rescue medication for breathlessness. Opioid therapy was judged to be very effective by the majority of patients suffering from breathlessness however caused (cancer-related or due to a benign disease e.g. chronic obstructive pulmonary disease). Conclusions: In a large cohort of patients breathlessness is a major topic and is clearly positively influenceable by opioids. In our opinion it is longtime overdue to strive for an authorization for opioids against breathlessness.

scholarly journals Correction: Palliative care team consultation and quality of death and dying in a university hospital: A secondary analysis of a prospective study

PLoS ONE ◽  
2018 ◽  
Vol 13 (11) ◽  
pp. e0208564 ◽  
Author(s):  
Arianne Brinkman-Stoppelenburg ◽  
Frederika E. Witkamp ◽  
Lia van Zuylen ◽  
Carin C. D. van der Rijt ◽  
Agnes van der Heide
Keyword(s):  
Palliative Care ◽  
Prospective Study ◽  
Death And Dying ◽  
Secondary Analysis ◽  
Palliative Care Team ◽  
Care Team ◽  
University Hospital ◽  
Quality Of Death ◽  
A Prospective Study

scholarly journals Palliative care team consultation and quality of death and dying in a university hospital: A secondary analysis of a prospective study

PLoS ONE ◽  
2018 ◽  
Vol 13 (8) ◽  
pp. e0201191 ◽  
Author(s):  
Arianne Brinkman-Stoppelenburg ◽  
Frederika E. Witkamp ◽  
Lia van Zuylen ◽  
Carin C. D. van der Rijt ◽  
Agnes van der Heide
Keyword(s):  
Palliative Care ◽  
Prospective Study ◽  
Death And Dying ◽  
Secondary Analysis ◽  
Palliative Care Team ◽  
Care Team ◽  
University Hospital ◽  
Quality Of Death ◽  
A Prospective Study
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