Effectiveness of a Home-Based Palliative Care Program for End-of-Life

Brumley, Richard; Enguídanos, Susan; Cherin, David A.

doi:10.1089/109662103322515220

Cited by 257 publications

(274 citation statements)

References 15 publications

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“…Outpatient palliative support may play an important role in addressing deficiencies in the care experience. [42][43][44] In terms of new interventions, the nature of this study does not permit specific recommendations, but the findings point to five needs that are consistently experienced by patients and their families and caregivers.…”

Section: Discussionmentioning

confidence: 99%

Living With Advanced Illness: Longitudinal Study of Patient, Family, and Caregiver Needs

Tallman¹,

Greenwald²,

Reidenouer³

et al. 2012

TPJ

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Section: Discussionmentioning

confidence: 99%

Living With Advanced Illness: Longitudinal Study of Patient, Family, and Caregiver Needs

Tallman¹,

Greenwald²,

Reidenouer³

et al. 2012

TPJ

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“…Home palliative care may prevent admissions to the hospital or emergency rooms, which are often unfit for this kind of patient, as the personnel there has no palliative care experience and is unaware of the patient's history and trajectory of disease. 15 This could potentially produce inappropriate admissions to the intensive care unit, where patients may be resuscitated despite orders to the contrary, and when palliative care may offer the best option. In a prospective study analyzing the profile of cancer patients admitted to an emergency department, the main reasons were the unavailability of beds in specialized cancer units and limited home care because of poor hospitalcommunity coordination and lack of social and psychological assistance.…”

Section: Discussionmentioning

confidence: 99%

Emergencies in Patients With Advanced Cancer Followed at Home

Mercadante

Porzio

Valle³

et al. 2012

Journal of Pain and Symptom Management

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Context. Patients with advanced cancer stay at home for most of their time, and acute problems may occur during home care. Caregivers may call medical services for an emergency, which can result in patients being admitted to the hospital. No data exist on emergencies in patients followed by a home care team.Objectives. The aim of this multicenter prospective study was to assess the frequency, reasons for, and subsequent course of emergency calls for patients followed at home by a palliative care team.Methods. A consecutive sample of patients admitted to home care programs was surveyed for a period of seven months. Epidemiological data, and characteristics of emergency calls and outcomes, as well as environmental situations were recorded.Results. Six hundred eighty-nine patients were surveyed; 118 patients (17.1% of the total number of patients surveyed) made one emergency call, 23 made two calls, and four made three calls for a total number of 176 emergency calls. The mean age was 71 years (standard deviation [SD] 13), and the mean Karnofsky status the day before the emergency call was 38 (SD 14). The mean time from admission to the first emergency call was 38.4 days (SD 67), and the mean time from the first emergency call to death was 17.5 days (SD 41.5). No differences were found for age, diagnosis, gender, duration of assistance, and survival between patients making emergency calls and those who did not make a call during an emergency. Twenty-three patients were managed by phone, and 122 were visited at home for the emergency. Calls were prevalently recorded on weekdays and were primarily made by relatives. The most frequent reasons for calling were dyspnea, pain, delirium, and loss of consciousness. Calls were considered justified by home care physicians in most cases. The mean number of relatives present during the

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“…For patients, involvement of SPCS improve the "quality of dying" [55], pain assessment and management of people dying in nursing homes [43,44] and symptomatic manage-ment in people admitted to hospital [26] and meet needs [54] and satisfaction with care [9,28,30]. For caregivers, SPCS involvement has been found to improve satisfaction [28,54] and reduce anxiety [30].…”

Section: Introductionmentioning

confidence: 99%

“…For caregivers, SPCS involvement has been found to improve satisfaction [28,54] and reduce anxiety [30]. In health service delivery, SPCS involvement reduced inpatient bed days [9,12] and decreased costs when compared to conventional care without shortening prognosis [9,52]. Systematic reviews of the impact of SPCS have been conducted and concluded that, while a benefit is suggested, data quality limits any conclusions [17-20, 24, 25].…”

Section: Introductionmentioning

confidence: 99%