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Outcomes of an integrated urology-palliative care clinic for patients with advanced urological cancers - maintenance of quality of life and satisfaction and high rate of hospice utilization through end of life

HUEN, Kathy ; HUANG, Cher ; LIU, Hui ; KWAN, Lorna ; PANNELL, Stephanie ; LAVIANA, Aaron ; SAUCEDO, Josemanuel ; LORENZ, Karl A. ; BENNETT, Carol ; BERGMAN, Jonathan
The American journal of hospice and palliative care, 26/02/2019, Pagination inconnue

Thème : Soins.

CANCER URO NEPHROLOGIQUE ; DEMARCHE PALLIATIVE ; QUALITE VIE ; SATISFACTION ; UNITE SOINS PALLIATIFS ; HOSPITALISATION JOUR ; FIN VIE ; ETATS-UNIS

INTRODUCTION: Systematic integration of palliative care in a surgical setting is important, but has yet to be achieved. Despite evidence of early palliative care improving patients' quality of life, hospice utilization remains low. Through an integrated palliative care-urology clinic, we aim to assess the effect of early outpatient palliative care on hospice utilization, health-related quality of life (HRQOL) and satisfaction in patients with advanced urological cancers.
METHODS: Participants were recruited from 2012 through 2016 in the Greater Los Angeles Veterans Affairs Hospital. We partnered with palliative care clinicians to develop an integrated urology-palliative care clinic, where participants were seen by the palliative care team on the same day as their urological visit. The 12-item Short-Form Survey, Patient Satisfaction Questionnaire Short-Form, Patient Health Questionnaire, and Brief Pain Inventory were administered at initial and subsequent visits. Follow-up questionnaire results were compared between baseline and the 2 follow-up visits, and hospice utilization rates were assessed.
RESULTS: Fifty-three participants completed baseline questionnaires. Of those 22 (42%) patients completed at least one follow-up assessment. The median time for the first and second follow-up visits was 2.9 and 7.8 months, respectively. There were no significant differences in HRQOL and satisfaction between baseline and subsequent follow-up visits. A total of 36 (68%) of 53 participants who were enrolled at the start of the study were deceased. Of those, 29 (81%) expired within a home or inpatient hospice.
CONCLUSIONS: Rates of hospice use were high in an integrated palliative care-urology model. Health-related quality of life and satisfaction did not worsen over time.

Origine : PubMed