دورية أكاديمية
The effect of a palliative care pathway on medical interventions at the end of life: a pre-post-implementation study.
| العنوان: | The effect of a palliative care pathway on medical interventions at the end of life: a pre-post-implementation study. |
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| المؤلفون: | van der Padt-Pruijsten A; Department of Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands. PruijstenA@maasstadziekenhuis.nl.; Department Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands. PruijstenA@maasstadziekenhuis.nl., Leys MBL; Department of Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands., Hoop EO; Department Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands., van der Heide A; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands., van der Rijt CCD; Department Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands. |
| المصدر: | Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2022 Nov; Vol. 30 (11), pp. 9299-9306. Date of Electronic Publication: 2022 Sep 07. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer International Country of Publication: Germany NLM ID: 9302957 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-7339 (Electronic) Linking ISSN: 09414355 NLM ISO Abbreviation: Support Care Cancer Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Berlin : Springer International, c1993- |
| مواضيع طبية MeSH: | Hospice and Palliative Care Nursing* , Neoplasms*/therapy , Terminal Care*/methods, Adult ; Humans ; Palliative Care/methods ; Quality of Life ; Death |
| مستخلص: | Purpose: Adequate integration of palliative care in oncological care can improve the quality of life in patients with advanced cancer. Whether such integration affects the use of diagnostic procedures and medical interventions has not been studied extensively. We investigated the effect of the implementation of a standardized palliative care pathway in a hospital on the use of diagnostic procedures, anticancer treatment, and other medical interventions in patients with incurable cancer at the end of their life. Methods: In a pre- and post-intervention study, data were collected concerning adult patients with cancer who died between February 2014 and February 2015 (pre-PCP period) or between November 2015 and November 2016 (post-PCP period). We collected information on diagnostic procedures, anticancer treatments, and other medical interventions during the last 3 months of life. Results: We included 424 patients in the pre-PCP period and 426 in the post-PCP period. No differences in percentage of laboratory tests (85% vs 85%, p = 0.795) and radiological procedures (85% vs 82%, p = 0.246) were found between both groups. The percentage of patients who received anticancer treatment or other medical interventions was lower in the post-PCP period (40% vs 22%, p < 0.001; and 42% vs 29%, p < 0.001, respectively). Conclusions: Implementation of a PCP resulted in fewer medical interventions, including anticancer treatments, in the last 3 months of life. Implementation of the PCP may have created awareness among physicians of patients' impending death, thereby supporting caregivers and patients to make appropriate decisions about medical treatment at the end of life. Trial Registration Number: Netherlands Trial Register; clinical trial number: NL 4400 (NTR4597); date registrated: 2014-04-27. (© 2022. The Author(s).) |
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BJGP Open. 4(4):bjgpopen20X101078. https://doi.org/10.3399/bjgpopen20X101078 . |
| فهرسة مساهمة: | Keywords: Anticancer treatment; Cancer; End-of-life care; Medical interventions; Palliative care pathway |
| تواريخ الأحداث: | Date Created: 20220907 Date Completed: 20221107 Latest Revision: 20230103 |
| رمز التحديث: | 20230104 |
| مُعرف محوري في PubMed: | PMC9633459 |
| DOI: | 10.1007/s00520-022-07352-4 |
| PMID: | 36071303 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1433-7339 |
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| DOI: | 10.1007/s00520-022-07352-4 |