Added Value of Early Consultation of an Inpatient Palliative Care Team in Hospitalized Older Patients With High Symptom Burden: A Prospective Comparative Study

Link to article at PubMed

Am J Hosp Palliat Care. 2020 Dec 30:1049909120982606. doi: 10.1177/1049909120982606. Online ahead of print.


BACKGROUND: It is estimated that in 2050 one quarter of the population in Europe will be aged 65 years and older. Although the added value of a palliative care team is emphasized in the literature, the impact of the palliative care team on the symptom burden in older non-cancer patients is not yet well established.

OBJECTIVES: To structurally measure symptoms and to investigate whether proactive consultation with a palliative care team results in improvement of symptoms.

DESIGN: This study has a prospective comparative design.

SETTING/PARTICIPANTS: Older patients, admitted to a Dutch University Medical Centre for who a health care professional had a negative response to the Surprise Question, were selected.

MEASUREMENTS, RESULTS: In period one, 59 patients completed the Utrecht Symptom Diary (USD) at day one of admission and after 7 days. In period 2 (n = 60), the same procedure was followed; additionally, the palliative care team was consulted for patients with high USD-scores. Significant improvement on the USD Total Distress Score (TSDS) was observed in both groups without a difference between the 2 periods. This study showed an association between consultation of the palliative care team and improvement on USD TSDS (adjusted odds ratio: 4.9; 95% confidence interval: 1.816-13.198), despite low follow-up rate of advices (approximately 50%).

CONCLUSIONS: This study emphasizes the importance of creating awareness for consulting the palliative care team. Further research should focus on assessing the reason behind the low follow-up rate of the advice given and understanding the specific advices contributing to symptom improvement.

PMID:33380163 | DOI:10.1177/1049909120982606

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