Implementing WHO Recommendations for Palliative Care into Routine Lung Cancer Therapy: A Feasibility Project

Gaertner, Jan; Wolf, Juergen; Scheicht, Dennis; Frechen, Sebastian; U, Klein; Hellmich, Martin; Ostgathe, Christoph; Hallek, Michael; Voltz, Raymond

doi:10.1089/jpm.2009.0399

Cited by 29 publications

(38 citation statements)

References 30 publications

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“…A number of studies from single centres looked at better access to care, acceleration of diagnostic steps, aspects of thoracic surgery, radiotherapy and integration of palliative care [23,25,[41][42][43]. In two independent studies by SALATI et al [44] and SCHWARZBACH et al [45], the implementation of a clinical pathway for thoracic surgery led to a reduction of hospital stay without negatively influencing readmission rates.…”

Section: Resultsmentioning

confidence: 99%

The European initiative for quality management in lung cancer care

Blum¹,

Rich²,

Baldwin³

et al. 2014

European Respiratory Journal

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Lung cancer is the commonest cause of cancer-related death worldwide and poses a significant respiratory disease burden. Little is known about the provision of lung cancer care across Europe. The overall aim of the Task Force was to investigate current practice in lung cancer care across Europe.The Task Force undertook four projects: 1) a narrative literature search on quality management of lung cancer; 2) a survey of national and local infrastructure for lung cancer care in Europe; 3) a benchmarking project on the quality of (inter)national lung cancer guidelines in Europe; and 4) a feasibility study of prospective data collection in a pan-European setting.There is little peer-reviewed literature on quality management in lung cancer care. The survey revealed important differences in the infrastructure of lung cancer care in Europe. The European guidelines that were assessed displayed wide variation in content and scope, as well as methodological quality but at the same time there was relevant duplication. The feasibility study demonstrated that it is, in principle, feasible to collect prospective demographic and clinical data on patients with lung cancer. Legal obligations vary among countries.The European Initiative for Quality Management in Lung Cancer Care has provided the first comprehensive snapshot of lung cancer care in Europe. Executive summaryThis European Respiratory Society (ERS) Task Force report describes the first phase of an ambitious initiative with the ultimate aim to improve the quality of care for people with lung cancer across Europe. The Task Force undertook four projects. 1) An extensive review of the literature on quality management revealed evidence that was mainly limited to individual aspects of quality improvement. 2) A baseline survey of national and local infrastructure of healthcare showed marked differences in resources and access to care among 37 countries. 3) A benchmarking project on the quality of guidelines showed that well-resourced guidelines were better. 4) A feasibility study showed that contemporary clinical data collection was possible through a clinical network representing 28 European countries. The Task Force has created a platform for future research and development of initiatives that may lead to improved care for people with lung cancer in Europe.

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Section: Resultsmentioning

confidence: 99%

The European initiative for quality management in lung cancer care

Blum¹,

Rich²,

Baldwin³

et al. 2014

European Respiratory Journal

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“…Here, green flags and red flags have been devised to develop standard operating procedures for an early integration approach. 29 Temel et al 30 were able to show that early palliative care led to significant improvements in both quality of life and mood in addition to prolonging life. That participants in our study see the integration as rather late in the disease trajectory might illustrate how misperceptions still exist and how a lack of information regarding palliative care, as identified earlier, 9,31 remains.…”

Section: (Expanded Disability Status Scale [Edss]mentioning

confidence: 99%

Palliative Care for Severely Affected Patients with Multiple Sclerosis: When and Why? Results of a Delphi Survey of Health Care Professionals

Strupp

Romotzky

Galushko

et al. 2014

Journal of Palliative Medicine

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Background: Patients severely affected by multiple sclerosis (MS) present with complex symptoms and needs requiring an interdisciplinary care approach. Objective: Analysis of when and why specialized palliative care integration would be beneficial via examining health care professionals' attitudes. Design: A two-round online Delphi study and expert workshop were undertaken and analyzed descriptively. Setting/Subjects: Following an extensive online search, 164 professionals with expertise in treating and caring for severely affected patients with MS were contacted. Professionals included neurologists, urologists, general practitioners, MS nurses, speech therapists, physiotherapists, psychologists, and palliative care physicians. Forty-six consented to participate: 33 of 46 (71.4%) and 15 of 33 (45.5%) experts responded in the first and second round, respectively. Results: Consensus was reached among all respondents (100%) defining the term ''severely affected'': 78.8% and 86.7%, respectively, thought that specialized palliative care should begin once the disease has progressed (Expanded Disability Status Scale [EDSS] > 6 and nursing care required). When the need exists for communication about disease progression (93.3%), psychological support (93.3%), relatives support (93.3%), and pain medication (86.7%) specialized palliative care should be consulted. Specialized palliative homecare was rated (93.3%) ''very important.'' The workshop documented the paucity of home visits and specialized MS care in nursing homes. Conclusions: Our results clearly identified specific areas in which palliative care will likely prove to be a valuable asset in the treatment course of MS. This information should serve clinicians, indicating when to consider palliative care services and help further reduce or eliminate uncertainty about how palliative care can be integrated in the course of MS.

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“…Paradigmatically, the SOP for comprehensive breast cancer therapy is presented here, since its therapeutic algorithm differs substantially from the SOPs for other solid tumors such as lung cancer [10,12] because of the clinical characteristics of the disease.…”

Section: Discussionmentioning

confidence: 99%

“…The evaluation of relevant pilot project data revealed that this approach was too vague to serve as a general clinical guideline to successfully implement early integration of PC [10,11]. As a consequence, in addition to inclusion in administrative directives and establishment of a PCST, we decided to develop standard operating procedures (SOPs) as diseasespecific guidelines to i) define disease-specific points in the Decision for Disease-Specific PC SOPs Because of the experiences described above, we decided that the sole adoption of the WHO recommendation in the administrative guidelines plus the provision of a PCST in addition to the preexisting home care service and inpatient ward did not suffice to integrate PC early enough.…”

Section: Time and Place Of Pc Integrationmentioning

confidence: 99%

Facilitating Early Integration of Palliative Care into Breast Cancer Therapy. Promoting Disease-Specific Guidelines

et al. 2011

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To comply with patients‘ needs as well as ASCO and WHO recommendations, our institution aims to integrate palliative care (PC) early in the course of breast cancer (BC) therapy. The evaluation of relevant pilot project data revealed that these recommendations were too vague to trigger PC integration. Therefore, a standard operating procedure (SOP) was developed by our interdisciplinary working group to provide disease-specific information to overcome the ambiguity of the WHO recommendations and guide PC integration. Literally, the SOP states that ‘Specialized PC is recommended regularly for all BC patients without curative treatment options, specifically for patients with i) metastasized and inoperable, or ii) locally advanced and inoperable, or iii) relapsing BC, who are receiving intravenous chemotherapy’. This SOP for the first time presents disease-specific guidelines for PC integration into comprehensive BC therapy by defining ‘green flags’ for early integration of PC and delineating PC from senology assignments. Although disease-specific SOPs have also been developed by this working group for other malignancies, the decision when to first integrate PC into BC therapy differs substantially because of the different clinical characteristics of the disease.

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Implementing WHO Recommendations for Palliative Care into Routine Lung Cancer Therapy: A Feasibility Project

Cited by 29 publications

References 30 publications

The European initiative for quality management in lung cancer care

The European initiative for quality management in lung cancer care

Palliative Care for Severely Affected Patients with Multiple Sclerosis: When and Why? Results of a Delphi Survey of Health Care Professionals

Facilitating Early Integration of Palliative Care into Breast Cancer Therapy. Promoting Disease-Specific Guidelines

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