Supportive and palliative care in hemato-oncology: how best to achieve seamless integration and subspecialty development?

Cheng, Hon Wai Benjamin; Lam, Ka On

doi:10.1007/s00277-020-04386-8

Cited by 19 publications

(35 citation statements)

References 36 publications

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“…Apart from improving patient's symptoms and mood, EHPC might also reduce the caregiver burden of MDS and AML patients in this trial. Previous literature had shown the benefits of PC interventions to assist family caregivers of patients with advanced medical disease in America and other countries (33). And the clinical outcomes of RCTs in cancer (34) and end-stage renal failure ( 19) also support this kind of PC intervention that could reduce caregiver burden and anxiety.…”

Section: Discussionmentioning

confidence: 94%

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Impact of enhanced haematology palliative care services in patients with myelodysplastic syndrome and acute myeloid leukaemia: study protocol for a randomized controlled trial

Chan

Gill

et al. 2021

Ann Palliat Med

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Background: Patients with acute myeloid leukaemia (AML) and myelodysplastic syndrome (MDS) suffer from a significant symptom burden and psychological, spiritual, social needs comparable to patients with solid metastatic malignancy. Referral to palliative care services for these haematological patients remains limited or often confined to the last days of life. We pioneered a palliative care (PC) program integrated with standard haematological care. The purpose of this trial will study the interventions by the PC team and preliminary results in the clinical outcomes.Methods: This project is a non-blinded, randomized, controlled trial. In this study, we examine the clinical outcomes of the integrated PC program for MDS/AML patients when the 2nd lines disease treatment failed and in the presence of prognostic indicators. In group 1, patients will receive standard haematological care associated with PC (i.e., intervention group). In contrast, in group 2, patients will receive standard haematological care only (i.e., control group) with PC service only on a request basis. Patients who join the program would have to complete a standardized questionnaire to assess their quality of life and their psychological and physical symptoms.Results: This is to exam the impact of the early integrated palliative care with enhanced psychosocial interventions to both advanced MDS/AML patients and their primary family members in Hong Kong.Discussion: This protocol will not display any result. If future results demonstrate that the enhanced PC interventions are effective, they will provide a quality treatment plan for patients with MDS/AML.

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Section: Discussionmentioning

confidence: 94%

“…Multiple factors (the disease nature, new advances in treatment, the level of care) might complicate the transition to PC. Other barriers for PC integration include limited published research specifically on HM patients' needs, misperceptions about PC as EOL, and lack of a clearly defined model of collaboration (32,33).…”

Section: Discussionmentioning

confidence: 99%

Impact of enhanced haematology palliative care services in patients with myelodysplastic syndrome and acute myeloid leukaemia: study protocol for a randomized controlled trial

Chan

Gill

et al. 2021

Ann Palliat Med

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“…The incidence was significantly reduced, with good safety. The second one enhances the work enthusiasm of nurses, broadens their theoretical and operational knowledge, promotes the level of friendly cooperation between teams, and improves the cohesion between teams [ 19 ]. Combined with the results of this study, it can be shown that medical staff is optimizing the dressing change process after the intervention, team cohesion, work responsibility, and communication skills were higher than those before intervention.…”

Section: Discussionmentioning

confidence: 99%

Application of Medical-Nursing Integration Multidisciplinary-Assisted Surgical Wound Nursing Mode in Improving the Quality of Wound Treatment

Wang

Yuan

Shi

2022

Emergency Medicine International

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Surgical treatment is a common clinical intervention for trauma, but postoperative pain and poor nursing lead to slow wound recovery and wound infection. Therefore, it is extremely important to select effective nursing intervention methods to improve the quality of wound treatment. This study explored the application value of the wound care model of medical integration and multidisciplinary-assisted surgery in improving the quality of wound treatment. The results show that medical-nursing integration in multidisciplinary-assisted surgical wound nursing mode can improve the quality of wound treatment and pain level in patients, which is beneficial to improving team cohesion of medical staff and satisfaction evaluation of patients.

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“…Palliative care is integrated earlier alongside standard antitumor treatment, with increased intent of palliative care gradually over time in this model. 27,28 Unfortunately, not all hematologists have the concept to integrate early palliative care collaboration because mistaking palliative care for end-of-life care or concerning differences in goals of care. 29 Based on the high in-hospital mortality rate in our cohort, our result supported the concept of concurrent model for early palliative care intervention to achieve better quality of life in patients with hematological malignancies.…”

Section: Discussionmentioning

confidence: 99%

Utility of Palliative Prognostic Index in Predicting Survival Outcomes in Patients With Hematological Malignancies in the Acute Ward Setting

Lee

Chou

Yang

et al. 2021

Am J Hosp Palliat Care

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Background: The palliative prognostic index (PPI) predicts the life expectancy of patients with terminally ill cancer in hospice settings. This study aimed to evaluate PPI as a prognostic tool for predicting the life expectancy of patients with hematological malignancies admitted to the acute ward. Methods: A total of 308 patients with hematological malignancies admitted to the hematological ward at a medical center between January 2016 and December 2017 were consecutively enrolled. PPI was scored within 24 h of admission. All patients were categorized into 3 groups by PPI for comparing survival and in-hospital mortality rates. Results: The median survival times were 38.4, 3.6, and 1.1 months for patients with good, intermediate, and poor prognostic group, respectively. The hazard ratio was 2.31 (95% CI 1.59-3.35, p < 0.001) when comparing the intermediate and good prognosis groups, and 3.90 (95% CI 2.52-6.03, p < 0.001) when comparing the poor and good prognosis groups. Forty-five (14.6%) patients died at discharge; in-hospital mortality rates among the good, intermediate, and poor prognostic groups were 9.0%, 23.4%, and 46.4%, respectively. The adjusted odds ratio for in-hospital mortality was 1.96 (95% CI, 0.80-4.82, p = 0.14) and 5.25 (95% CI, 2.01-13.7, p < 0.001) for patients in the intermediate and poor prognostic groups compared to those in the good prognostic group. Conclusion: PPI is an accurate prognostic tool for predicting survival times and in-hospital mortality rates in patients with hematological malignancies in an acute ward setting. PPI could assist clinicians in discussing end-of-life issues and in referring patients with hematological malignancies to palliative care.

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Supportive and palliative care in hemato-oncology: how best to achieve seamless integration and subspecialty development?

Cited by 19 publications

References 36 publications

Impact of enhanced haematology palliative care services in patients with myelodysplastic syndrome and acute myeloid leukaemia: study protocol for a randomized controlled trial

Impact of enhanced haematology palliative care services in patients with myelodysplastic syndrome and acute myeloid leukaemia: study protocol for a randomized controlled trial

Application of Medical-Nursing Integration Multidisciplinary-Assisted Surgical Wound Nursing Mode in Improving the Quality of Wound Treatment

Utility of Palliative Prognostic Index in Predicting Survival Outcomes in Patients With Hematological Malignancies in the Acute Ward Setting

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