Sebastiano Mercadante1, Paolo Marchetti2, Claudio Adile3, Amanda Caruselli4, Patrizia Ferrera3, Andrea Costanzi2, Alessandra Casuccio5. 1. Anesthesia and Intensive Care Unit and Pain Relief and Supportive-Palliative Care Unit, La Maddalena Cancer Center, Via san Lorenzo 312, 90145, Palermo, Italy. terapiadeldolore@lamaddalenanet.it. 2. Department of Oncology, Hospital Sant'Andrea, University of Rome, Rome, Italy. 3. Anesthesia and Intensive Care Unit and Pain Relief and Supportive-Palliative Care Unit, La Maddalena Cancer Center, Via san Lorenzo 312, 90145, Palermo, Italy. 4. Regional Palliative Care program, SAMO, Palermo, Italy. 5. Department of Sciences for Health Promotion and Mother Child care, University of Palermo, Palermo, Italy.
Abstract
BACKGROUND: A supportive palliative care unit (SPCU) may have a positive impact on patients' care. The aim of this study was to compare the pattern of patients admitted to a specialized SPCU and to a traditional oncologic ward (OW) in a consecutive sample of advanced cancer patients. METHODS: Data on patients demographics, reasons for and kind of admission, care-giver, anticancer treatments, being on/off treatment or uncertain, origin setting, who proposed hospital admission, the use of opioids, and hospitalization were gathered. The same parameters were recorded at discharge. A follow-up was performed by phone 1 month after discharge. RESULTS: Two-hundred patients were surveyed. Awareness of disease was more complete in OW patients (P = 0.001). Uncontrolled pain and symptoms were the prevalent reasons for admission to SPCU (P < 0.0005). Toxicity from chemotherapy was more frequently reported by OW patients (P = 0.001). SPCU patients received higher doses of opioids (P = 0.004). More SPCU patients were referred from home and were discharged home (P < 0.0005 and P = 0.018, respectively). Emergency admissions were more frequently reported in OW patients (P < 0.0005). One month after, more SPCU patients were at home and were still on active treatment (P = 0.002, and P = 0.05, respectively). More OW patients died within 1 month (P = 0.001). CONCLUSION: SPCU allows a better planning admission to hospital and a better care trajectory in advanced cancer patients in comparison to a busy OW, where unselected emergencies more frequently occur.
BACKGROUND: A supportive palliative care unit (SPCU) may have a positive impact on patients' care. The aim of this study was to compare the pattern of patients admitted to a specialized SPCU and to a traditional oncologic ward (OW) in a consecutive sample of advanced cancerpatients. METHODS: Data on patients demographics, reasons for and kind of admission, care-giver, anticancer treatments, being on/off treatment or uncertain, origin setting, who proposed hospital admission, the use of opioids, and hospitalization were gathered. The same parameters were recorded at discharge. A follow-up was performed by phone 1 month after discharge. RESULTS: Two-hundred patients were surveyed. Awareness of disease was more complete in OW patients (P = 0.001). Uncontrolled pain and symptoms were the prevalent reasons for admission to SPCU (P < 0.0005). Toxicity from chemotherapy was more frequently reported by OW patients (P = 0.001). SPCU patients received higher doses of opioids (P = 0.004). More SPCU patients were referred from home and were discharged home (P < 0.0005 and P = 0.018, respectively). Emergency admissions were more frequently reported in OW patients (P < 0.0005). One month after, more SPCU patients were at home and were still on active treatment (P = 0.002, and P = 0.05, respectively). More OW patients died within 1 month (P = 0.001). CONCLUSION: SPCU allows a better planning admission to hospital and a better care trajectory in advanced cancerpatients in comparison to a busy OW, where unselected emergencies more frequently occur.
Entities:
Keywords:
Advanced cancer patients; Emergency; Hospital admission; Palliative care; Supportive care
Authors: Glenn Gade; Ingrid Venohr; Douglas Conner; Kathleen McGrady; Jeffrey Beane; Robert H Richardson; Marilyn P Williams; Marcia Liberson; Mark Blum; Richard Della Penna Journal: J Palliat Med Date: 2008-03 Impact factor: 2.947
Authors: Gabrielle B Rocque; Anne E Barnett; Lisa C Illig; Jens C Eickhoff; Howard H Bailey; Toby C Campbell; James A Stewart; James F Cleary Journal: J Oncol Pract Date: 2013-01 Impact factor: 3.840