scholarly journals Palliative care consultation team: symptom relief in first 48 hours of hospitalization

2020 ◽  
Vol 73 (6) ◽  
Author(s):  
Magda Aparecida dos Santos Silva ◽  
Marcio Augusto Diniz ◽  
Ricardo Tavares de Carvalho ◽  
Toshio Chiba ◽  
Cibele Andrucioli de Mattos-Pimenta
Keyword(s):  
Palliative Care ◽  
Pain Relief ◽  
Symptom Relief ◽  
Symptom Assessment ◽  
Assessment System ◽  
Point Reduction ◽  
Palliative Care Consultation ◽  
Symptom Intensity ◽  
Consultation Team ◽  
Care Consultation

ABSTRACT Objective: To compare the relief of symptoms provided by palliative care consultation team (PCCT) compared to the traditional care team (TC), in patients with advanced cancer in the first 48 hours of hospitalization. Method: Allocated to PCCT Group and TC Group, this study assessed 290 patients according to the Edmonton Symptom Assessment System (ESAS) within the first 48 hours of hospitalization. The main outcome was a minimum 2-point reduction in symptom intensity. Results: At 48 hours, the PCCT Group had a 2-point reduction in the mean differences (p <0.001) in pain, nausea, dyspnea, and depression; and TC Group, on nausea and sleep impairment (p <0.001). Multiple Logistic Regression found for the PCCT Group a greater chance of pain relief (OR 2.34; CI 1.01-5.43; p = 0.049). Conclusion: There was superiority of the PCCT Group for pain relief, dyspnea and depression. There is a need for more studies that broaden the understanding of team modalities.

Change in symptom burden within one day of palliative care consultation in a cohort of gynecologic oncology inpatients.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 28-28
Author(s):  
Carolyn Lefkowits ◽  
Winifred Teuteberg ◽  
Madeleine Courtney-Brooks ◽  
Paniti Sukumvanich ◽  
Joseph L. Kelley
Keyword(s):  
Palliative Care ◽  
Symptom Management ◽  
Severe Symptom ◽  
Symptom Relief ◽  
Gynecologic Oncology ◽  
Symptom Burden ◽  
Assessment System ◽  
Palliative Care Consultation ◽  
Symptom Intensity ◽  
Care Consultation

28 Background: Change in symptom burden after inpatient palliative care consultation for symptom management in gynecologic oncology patients has not been described. Our objective was to evaluate the magnitude and time course of change in symptom burden after palliative care (PC) consultation in a cohort of gynecologic oncology inpatients. Methods: Women with a gynecologic malignancy and a PC consultation for symptom management between 3/1/12 and 2/28/13 were identified. Charts were reviewed for demographics and disease characteristics. PC provider reports of patient symptom intensity on a modified Edmonton Symptom Assessment System were retrospectively reviewed. Data was analyzed with descriptive statistics and two sample test of proportions to compare prevalence of moderate to severe symptom intensity on the day of consultation to the day after consultation. Results: Over 12 months, there were 172 PC consultations for symptom management involving 123 unique patients. The median age was 58 and most common cancer was ovarian (44%), followed by cervical (26%) and uterine (24%). Prevalence of moderate to severe symptoms on the day of consultation is outlined below. There were statistically significant decreases in prevalence of moderate to severe symptom intensity within one day of PC consultation for pain, anorexia, fatigue and shortness of breath (SOB) (see table). Conclusions: PC consultation is associated with significant improvements in symptoms within one day of consultation. Palliative care consultation may be an effective tool for symptom management during even very short hospitalizations and should be considered early in the hospitalization to effect timely symptom relief. [Table: see text]

scholarly journals Barriers and Facilitators to Effective Inpatient Palliative Care Consultations: A Qualitative Analysis of Interviews With Palliative Care and Nonpalliative Care Providers

2018 ◽  
Vol 36 (3) ◽  
pp. 191-199 ◽  
Author(s):  
Meghan McDarby ◽  
Brian D. Carpenter
Keyword(s):  
Palliative Care ◽  
Nurse Practitioners ◽  
Care Service ◽  
Palliative Care Service ◽  
Educational Interventions ◽  
Care Providers ◽  
Palliative Care Consultation ◽  
Consultation Team ◽  
Care Consultation ◽  
Successful Collaboration

Objective: To identify factors that hinder or facilitate the palliative care consultation team’s (PCCT) successful collaboration with other providers from the perspectives of both PCCT and nonpalliative specialists. Methods: Qualitative study, including semistructured interviews with PCCT and nonpalliative care providers from various specialties at 4 Midwestern hospitals. Interviews were audio-recorded and transcribed into written text documents for thematic analysis. Palliative care consultation team (n = 19) and nonpalliative care providers (n = 29) were interviewed at their respective hospital sites or via telephone. Palliative care consultation team providers included physicians, nurse practitioners, registered nurses, social workers, and one chaplain. Specialists included critical care physicians, surgeons, hospitalists, nephrologists, oncologists, and cardiologists. Results: Six themes emerged reflecting barriers to and facilitators of successful collaboration between the PCCT and other providers. Primary barriers included attitudes about palliative care, lack of knowledge about the role of the PCCT, and patient and family resistance. Facilitators included marketing of the palliative care service and education about the expertise of the PCCT. Conclusion: In order to engage in more effective collaboration with other specialty providers, the PCCT may consider strategies including structured educational interventions, increased visibility in the hospital, and active marketing of the utility of palliative care across disciplines.

scholarly journals Impact of a new palliative care consultation team on opioid prescription in a University Hospital

2009 ◽  
Vol 8 (1) ◽  
Author(s):  
Carlos Centeno ◽  
María Angustias Portela ◽  
Antonio Noguera ◽  
Antonio Idoate ◽  
Álvaro Sanz Rubiales
Keyword(s):  
Palliative Care ◽  
University Hospital ◽  
Opioid Prescription ◽  
Palliative Care Consultation ◽  
Consultation Team ◽  
Care Consultation

Cost analysis of a prospective multi-site cohort study of palliative care consultation teams for adults with advanced cancer: Where do cost-savings come from?

2017 ◽  
Vol 31 (4) ◽  
pp. 378-386 ◽  
Author(s):  
Peter May ◽  
Melissa M Garrido ◽  
J Brian Cassel ◽  
Amy S Kelley ◽  
Diane E Meier ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cohort Study ◽  
Length Of Stay ◽  
Advanced Cancer ◽  
Intervention Group ◽  
Cost Savings ◽  
Early Palliative Care ◽  
Palliative Care Consultation ◽  
Consultation Team ◽  
Care Consultation

Background: Studies report cost-savings from hospital-based palliative care consultation teams compared to usual care only, but drivers of observed differences are unclear. Aim: To analyse cost-differences associated with palliative care consultation teams using two research questions: (Q1) What is the association between early palliative care consultation team intervention, and intensity of services and length of stay, compared to usual care only? (Q2) What is the association between early palliative care consultation team intervention and day-to-day hospital costs, compared to a later intervention? Design: Prospective multi-site cohort study (2007–2011). Patients who received a consultation were placed in the intervention group, those who did not in the comparison group. Intervention group was stratified by timing, and groups were matched using propensity scores. Setting/participants: Adults admitted to three US hospitals with advanced cancer. Principle analytic sample contains 863 patients ( nUC = 637; nPC EARLY = 177; nPC LATE = 49) discharged alive. Results: Cost-savings from early palliative care accrue due to both reduced length of stay and reduced intensity of treatment, with an estimated 63% of savings associated with shorter length of stay. A reduction in day-to-day costs is observable in the days immediately following initial consult but does not persist indefinitely. A comparison of early and late palliative care consultation team cost-effects shows negligible difference once the intervention is administered. Conclusion: Reduced length of stay is the biggest driver of cost-saving from early consultation for patients with advanced cancer. Patient- and family-centred discussions on goals of care and transition planning initiated by palliative care consultation teams may be at least as important in driving cost-savings as the reduction of unnecessary tests and pharmaceuticals identified by previous studies.

Clinical Findings of a Palliative Care Consultation Team at a Comprehensive Cancer Center

2008 ◽  
Vol 11 (2) ◽  
pp. 191-197 ◽  
Author(s):  
Navneet Dhillon ◽  
Scott Kopetz ◽  
Be Lian Pei ◽  
Egidio Del Fabbro ◽  
Tao Zhang ◽  
...  
Keyword(s):  
Palliative Care ◽  
Clinical Findings ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Palliative Care Consultation ◽  
Consultation Team ◽  
Care Consultation
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