Interventions and symptom relief in hospital palliative cancer care: results from a prospective longitudinal study.
Acute palliative care unit (APCU)
Cancer
Integration
Palliative
Symptom development
Symptoms
Journal
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
ISSN: 1433-7339
Titre abrégé: Support Care Cancer
Pays: Germany
ID NLM: 9302957
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
28
01
2021
accepted:
20
04
2021
pubmed:
5
5
2021
medline:
16
10
2021
entrez:
4
5
2021
Statut:
ppublish
Résumé
To study the use of interventions and symptom relief for adult patients with incurable cancer admitted to an acute palliative care unit providing integrated oncology and palliative care services. All admissions during 1 year were assessed. The use of interventions was evaluated for all hospitalizations. Patients with assessments for worst and average pain intensity, tiredness, drowsiness, nausea, appetite, dyspnea, depression, anxiety, well-being, constipation, and sleep were evaluated for symptom development during hospitalization. Descriptive statistics was applied for the use of interventions and the paired sample t-test to compare symptom intensities (SIs). For 451 admissions, mean hospital length of stay was 7.0 days and mean patient age 69 years. More than one-third received systemic cancer therapy. Diagnostic imaging was performed in 66% of the hospitalizations, intravenous rehydration in 45%, 37% received antibiotics, and 39% were attended by the multidisciplinary team. At admission and at discharge, respectively, 55% and 44% received oral opioids and 27% and 45% subcutaneous opioids. For the majority, opioid dose was adjusted during hospitalization. Symptom registrations were available for 180 patients. Tiredness yielded the highest mean SI score (5.6, NRS 0-10) at admission and nausea the lowest (2.2). Significant reductions during hospitalization were reported for all assessed SIs (p ≤ 0.01). Patients receiving systemic cancer therapy reported symptom relief similar to those not on systemic cancer therapy. Clinical practice and symptom relief during hospitalization were described. Symptom improvements were similar for oncological and palliative care patients.
Identifiants
pubmed: 33942192
doi: 10.1007/s00520-021-06248-z
pii: 10.1007/s00520-021-06248-z
pmc: PMC8464577
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
6595-6603Informations de copyright
© 2021. The Author(s).
Références
J Pain Symptom Manage. 2016 Jun;51(6):1070-1090.e9
pubmed: 27112310
Cancer. 2015 Sep 1;121(17):3027-35
pubmed: 26059846
J Palliat Med. 2010 Jan;13(1):49-57
pubmed: 19824813
PLoS One. 2016 Jun 22;11(6):e0157300
pubmed: 27332884
J Cardiothorac Vasc Anesth. 2018 Dec;32(6):2789-2801
pubmed: 29571641
Int J Qual Health Care. 2016 Sep;28(4):456-69
pubmed: 27353273
Support Care Cancer. 2020 Feb;28(2):671-682
pubmed: 31123870
J Pain Symptom Manage. 2005 Oct;30(4):367-73
pubmed: 16256901
J Pain Symptom Manage. 2016 Jun;51(6):1013-9
pubmed: 26921493
Palliat Med. 2016 Jun;30(6):587-98
pubmed: 26763008
Scand J Pain. 2017 Oct;17:99-106
pubmed: 28850380
Palliat Med. 2006 Sep;20(6):617-22
pubmed: 17060255
Pain. 2010 Jun;149(3):476-482
pubmed: 20236762
PLoS One. 2019 Oct 9;14(10):e0222988
pubmed: 31596849
N Engl J Med. 2007 Aug 9;357(6):608-13
pubmed: 17687138
ESMO Open. 2018 Jul 11;3(5):e000372
pubmed: 30018816
J Pain Symptom Manage. 2007 Jul;34(1):94-104
pubmed: 17509812
Ann Oncol. 2007 Sep;18(9):1437-49
pubmed: 17355955
Lancet Oncol. 2018 Nov;19(11):e588-e653
pubmed: 30344075
J Clin Oncol. 2016 Feb 20;34(6):557-65
pubmed: 26644527
Ann Oncol. 2017 Sep 1;28(9):2057-2066
pubmed: 28911084
J Palliat Med. 2019 Oct;22(10):1252-1259
pubmed: 31063024
J Pain Symptom Manage. 2015 May;49(5):945-52
pubmed: 25523890
Cancers (Basel). 2020 Jan 15;12(1):
pubmed: 31952220
J Pain Symptom Manage. 2017 Mar;53(3):630-643
pubmed: 28042071
Support Care Cancer. 2016 Jun;24(6):2565-74
pubmed: 26712631
J Palliat Care. 1991 Summer;7(2):6-9
pubmed: 1714502
J Clin Oncol. 2011 Mar 20;29(9):1151-8
pubmed: 21300920
J Opioid Manag. 2009 Jan-Feb;5(1):11-21
pubmed: 19344044
JAMA. 2017 Jul 11;318(2):197-198
pubmed: 28586821
Am J Hosp Palliat Care. 2011 Dec;28(8):550-5
pubmed: 21478176
BMC Palliat Care. 2016 Mar 11;15:32
pubmed: 26968159
Eur J Cancer. 2014 Mar;50(5):953-62
pubmed: 24424105
J Clin Oncol. 2014 Jun 1;32(16):1727-33
pubmed: 24799490
Support Care Cancer. 2018 Nov;26(11):3951-3958
pubmed: 29850945
J Palliat Med. 2012 Mar;15(3):301-7
pubmed: 22339287
Lancet. 2017 Jul 8;390(10090):102-104
pubmed: 28077229
JAMA. 2012 Apr 11;307(14):1513-6
pubmed: 22419800
BMJ Support Palliat Care. 2011 Dec;1(3):281-7
pubmed: 24653469