Abstract
Automatic inpatient palliative care consultation (PCC): Too little, too late to impact quality of life for advanced cancer patients?
Journal of clinical oncology, Vol.31(15_suppl), pp.e20565-e20565
05/20/2013
DOI: 10.1200/jco.2013.31.15_suppl.e20565
Abstract
Abstract only
e20565
Background: Patients with advanced cancer who are hospitalized have high symptom burden and a short life expectancy, which may warrant PCC. Methods: Using sequential cohorts, we prospectively assessed implementation of automatic PCC for hospitalized cancer patients. The primary outcome was hospice utilization. Secondary outcomes included evaluation of changes in quality of life (FACIT-PAL), symptoms (ESAS), satisfaction (FAMCARE), and anxiety and depression (HADS). Surveys were administered at baseline, 2 weeks and 3 months post-hospitalization. Chart abstraction was utilized to assess demographics, resource use, and survival information. Results: Patients were evaluated consecutively (65 in the control group, 70 in the intervention). At admission, 91% reported uncontrolled symptoms: 52% pain; 15% dyspnea. 60% of intervention patients received PCC during their first admission. 54 patients completed surveys (29 control group, 25 PCC group), 64 patients declined or were unable to complete surveys, 16 patients were excluded due to language barriers, physician preference, or not receiving surveys. Using an intent-to-treat analysis, there was no difference between patients in the control and the intervention group in FACIT-PAL (119 ± 29 vs 123 ± 30, p = 0.68 ), ESAS (28 ± 14 vs 26 ± 15, p = 0.74) HADS (13 ± 6.6 vs. 12.± 4.7, p = 0.58), or FAMCARE (58 ± 9.1 vs 59 ± 8.6, p = 0.61). In both groups, patients had modest worsening of symptoms and quality of life over the course of the study. Survival and Health Services data analysis, including hospice referral, is proceeding. Conclusions: Automatic PPC had little impact on patient-reported symptoms and quality of life. Limitations included: small patient population; high rate of incomplete surveys, likely due to illness burden; penetration of the PCC was limited to 60% by patient or provider preference and consultant availability. Our primary outcome analysis (hospice utilization) is forthcoming, as are data on survival and Health Services outcomes.
Details
- Title: Subtitle
- Automatic inpatient palliative care consultation (PCC): Too little, too late to impact quality of life for advanced cancer patients?
- Creators
- Gabrielle Betty Rocque - University of Wisconsin Carbone Cancer CenterToby Christopher Campbell - University of Wisconsin Carbone Cancer CenterAnne Elizabeth Barnett - University of Wisconsin Carbone Cancer CenterRenae M Quale - University of Wisconsin Carbone Cancer CenterJens C. Eickhoff - University of Wisconsin–MadisonHoward Harry Bailey - University of Wisconsin Carbone Cancer CenterMark E. Burkard - University of Wisconsin Carbone Cancer CenterJames F. Cleary - University of Wisconsin Carbone Cancer Center
- Resource Type
- Abstract
- Publication Details
- Journal of clinical oncology, Vol.31(15_suppl), pp.e20565-e20565
- DOI
- 10.1200/jco.2013.31.15_suppl.e20565
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Language
- English
- Date published
- 05/20/2013
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984700644902771
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