Treatment effects of palliative care consultation and patient contentment: A monocentric observational study.
Aged
Aged, 80 and over
Cancer Pain
/ diagnosis
Female
Humans
Male
Middle Aged
Neoplasms
/ complications
Pain Measurement
/ statistics & numerical data
Palliative Care
/ psychology
Patient Reported Outcome Measures
Patient Satisfaction
/ statistics & numerical data
Program Evaluation
Referral and Consultation
/ organization & administration
Retrospective Studies
Terminally Ill
/ psychology
Treatment Outcome
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
26 Mar 2021
26 Mar 2021
Historique:
received:
09
05
2020
accepted:
22
12
2020
entrez:
25
3
2021
pubmed:
26
3
2021
medline:
7
4
2021
Statut:
ppublish
Résumé
Palliative care is a central component of the therapy in terminally ill patients. During treatment in non-palliative departments this can be realized by consultation.To analyze the change in symptom burden during palliative care consultation.In this observational study, we enrolled all cancer cases (n = 163) receiving inpatient treatment for 2015 to 2018 at our institution. We used the MDASI-questionnaire (0 = 'not present' and 10 = "as bad as you can imagine") and the FAMCARE-6 (1 = very satisfied, 5 = very dissatisfied) to analyze the treatment effect and patient satisfaction, respectively.We examined the association of symptom burden and patient satisfaction using Spearman-correlation. Comparing mean values, we applied the Wilcoxon-test and one-way ANOVA.An improvement in MDASI-core-items after treatment completion was significant (P < .05) in 14/18 symptoms. The change in perception of pain showed the strongest improvement (median: 5 to 3). Initially the MDASI-items "activity" (median = 8) and emotional distress (median = 5 and 6) were viewed as especially incriminating. There was no evidence for a correlation between patients' age, the type of diagnosis and time since diagnosis.The analysis of FAMCARE-6 patient contentment was lower or equal to two in all of the six items. There was a weak negative association between the change in symptom burden of psycho-emotional items "distress/feeling upset" (P = .006, rSp = -0,226), "sadness" and patient satisfaction in FAMCARE-6.A considerable improvement of the extensive symptom burden particularly of pain relief was achieved by integrating palliative consultation in clinical practice.
Identifiants
pubmed: 33761631
doi: 10.1097/MD.0000000000024320
pii: 00005792-202103260-00007
pmc: PMC9282054
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e24320Subventions
Organisme : Funding programme Open Access Publishing by the German Research Foundation (DFG)
ID : no
Informations de copyright
Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
Références
Statistisches Bundesamt. Todesursachen: Zahl der Todesfälle im Jahr 2016 um 1,5% gesunken ; 2019 [07.04.2019]. Available at: https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Gesundheit/Todesursachen/todesfaelle-2016.html;jsessionid=20570BCF6BDACBCCB7AF7070DE00AE46.internet742 . Accessed April 7, 2019.
Deutsche Gesellschaft für Palliativmedizin. Deutsche Gesellschaft für Palliativmedizin: Definitionen zur Hospiz- und Palliativversorgung ; 2016 [07.04.2019]. Available at: https://www.dgpalliativmedizin.de/images/DGP_GLOSSAR.pdf . Accessed April 7, 2019.
Leitlinienprogramm Onkologie. S3-Leitlinie: Palliativmedizin für Patienten mit einer nicht heilbaren Krebserkrankung: Kurzversion ; 2015 [12.04.2019]. Available at: https://dgpalliativmedizin.de/images/stories/LL_Palliativmedizin_Kurzversion_1.1.pdf . Accessed April 12, 2019.
Leitlinienprogramm Onkologie. erweiterte S3-Leitlinie Palliativmedizin ; 2019 [20.11.2019]. Available at: https://www.leitlinienprogramm-onkologie.de/fileadmin/user_upload/Downloads/Leitlinien/Palliativmedizin/Version_2/LL_Palliativmedizin_2.0_Kurzversion.pdf . Accessed November 20, 2019.
Erlenwein J, Petzke F, Stamer U, et al. Rolle der Anästhesiologie in der schmerzmedizinischen und palliativmedizinischen Versorgung in deutschen Krankenhäusern. Der Anaesthesist 2017;66:579–88.
Parikh RB, Kirch RA, Smith TJ, et al. Early specialty palliative care—translating data in oncology into practice. N Engl J Med 2013;369:2347–51.
Zimmermann C, Swami N, Krzyzanowska M, et al. Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. Lancet 2014;383:1721–30.
Hanson LC, Usher B, Spragens L, Bernard S. Clinical and economic impact of palliative care consultation. J Pain Symptom Manage 2008;35:340–6.
Penrod JD, Deb P, Dellenbaugh C, et al. Hospital-based palliative care consultation: effects on hospital cost. J Palliat Med 2010;13:973–9.
Penrod JD, Deb P, Luhrs C, et al. Cost and utilization outcomes of patients receiving hospital-based palliative care consultation. J Palliat Med 2006;9:855–60.
Jordhøy MS, Fayers P, Saltnes T, et al. A palliative-care intervention and death at home: a cluster randomised trial. Lancet 2000;356:888–93.
Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non–small-cell lung cancer. N Engl J Med 2010;363:733–42.
Bakitas M, Lyons KD, Hegel MT, et al. Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the Project ENABLE II randomized controlled trial. JAMA 2009;302:741–9.
Stanhope J. Brief Pain Inventory review. Occup Med 2016;66:496–7.
Cleeland CS, Ryan K. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singap 1994;23:129–38.
Schmidt H, Cleeland CS, Bauer A, et al. Symptom burden of cancer patients: validation of the German MD Anderson Symptom Inventory: a cross-sectional multicenter study. J Pain Symptom Manage 2015;49:117–25.
Mehnert A, Müller D, Lehmann C, Koch U. Die deutsche Version des NCCN Distress-Thermometers. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie 2006;54:213–23.
Petermann F. Hospital anxiety and depression scale, deutsche version (HADS-D). Zeitschrift für Psychiatrie, Psychologie und Psychotherapie 2011;59:251–3.
Snaith RP, Zigmond AS. The hospital anxiety and depression scale. Brit Med J (Clin Res Ed) 1986;292:344.
Oken MM, Creech RH, Tormey DC, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 1982;5:649–56.
Bridgewater J, Lopes A, Wasan H, et al. Prognostic factors for progression-free and overall survival in advanced biliary tract cancer. Ann Oncol 2015;27:134–40.
Karnofsky DA, Abelmann WH, Craver LF, Burchenal JH. The use of the nitrogen mustards in the palliative treatment of carcinoma. With particular reference to bronchogenic carcinoma. Cancer 1948;1:634–56.
Carter GL, Lewin TJ, Gianacas L, et al. Caregiver satisfaction with out-patient oncology services: utility of the FAMCARE instrument and development of the FAMCARE-6. Support Care Cancer 2011;19:565–72.
Jones D, Vichaya EG, Cleeland CS, et al. Screening for depressed mood in patients with cancer using the MD Anderson Symptom Inventory: investigation of a practical approach for the oncologist. J Oncol Pract 2013;10:e95–102.
Cleeland CS. The M.D.Anderson Symptom Inventory: User Guide. 2010 [12.04.2019]. Available at: https://www.mdanderson.org/documents/Departments-and-Divisions/Symptom-Research/MDASI_userguide.pdf . Accessed April 12, 2019.
Mendoza TR, Wang XS, Lu C, et al. Measuring the symptom burden of lung cancer: the validity and utility of the lung cancer module of the MD Anderson Symptom Inventory. Oncologist 2011;16:217–27.
Kristjanson LJ. Validity and reliability testing of the FAMCARE Scale: measuring family satisfaction with advanced cancer care. Soc Sci Med 1993;36:693–701.
Pommer P. Psychoonkologie–Krebsdiagnose erhöht Suizidrate und kardiovaskuläres Sterberisikio. Psychother Psychosomatik· Med Psychol 2012;62:442–1442.
Schwarz R, Götze H. Psychoonkologie. Psychotherapeut 2008;53:221–35.
Mehnert A, Lehmann C, Koch U. Prävalenz und Diagnostik psychischer Störungen in der Onkologie. Der Onkologe 2006;12:18–26.
Brutsche MH. Screening fürs Lungenkarzinom-ein Kampf gegen Windmühlen? Swiss Med Forum 2003;3:653–4.
Kasenda B, Raatz H, Bucher HC. Früherkennung von Lungenkrebs–eine Übersicht über Chancen und Risiken. Therapeutische Umschau 2013;70:237.
Lahmann C, Dinkel A. Ärztliche Gesprächsführung—eine hohe Kunst. MMW-Fortschritte der Medizin 2014;156:85–90.
Derksen F, Bensing J, Lagro-Janssen A. Effectiveness of empathy in general practice: a systematic review. Brit J Gen Pract 2013;63:e76–84.