Optimizing End-of-Life Care for Patients With Hematological Malignancy: Rethinking the Role of Palliative Care Collaboration

Cheng, Hon Wai Benjamin

doi:10.1016/j.jpainsymman.2015.01.008

Cited by 13 publications

(10 citation statements)

References 10 publications

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“…It is crucial that palliative care be well coordinated to address the needs of these patients. A similar success by using this collaborative model can be seen with hematology teams of local hospitals [ 11 ]. Our joint care model in Hong Kong provided a good learning opportunity for both specialists in palliative care and nephrology, and, hopefully, patients will benefit from our joint effort in care.…”

Section: Discussionmentioning

confidence: 77%

Palliative Care for a Mentally Incompetent End Stage Renal Failure Patient: Why Is It Important?

Chan

Yip

Sham

et al. 2015

Case Reports in Nephrology

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Section: Discussionmentioning

confidence: 77%

Palliative Care for a Mentally Incompetent End Stage Renal Failure Patient: Why Is It Important?

Chan

Yip

Sham

et al. 2015

Case Reports in Nephrology

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“…Additionally, appropriate PC referral should be made based on good collaboration among various clinical teams, namely, hematology and PC team, based on particular conditions of patients to optimize endof-life care for patients undergoing HSCT with hematological malignancy. 39 Overall, in-hospital mortality was significantly higher in patients who received PC when compared with those who did not. However, it did not mean that PC use could increase risk of in-hospital mortality in patients undergoing HSCT.…”

Section: Discussionmentioning

confidence: 90%

Utilization of Palliative Care for Patients Undergoing Hematopoietic Stem Cell Transplantation During Hospitalization: A Population-Based National Study

Han

Liu²,

Qin

et al. 2019

Am J Hosp Palliat Care

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Objective: Patients undergoing hematopoietic stem cell transplantation (HSCT) have substantial physical and psychological symptoms. This study aimed to investigate the utilization of palliative care (PC) in patients undergoing HSCT during hospitalization. Methods: The 2008-2014 National Inpatient Sample was queried for eligible participants. Demographics, hospital characteristics, comorbidities, posttransplantation complications, and inpatient procedures were compared between patients with and without PC. Multivariate logistic regression was performed to identify predictors associated with PC use. Results: Among 21 458 patients undergoing HSCT during hospitalization, 278 (1.30%) received PC. The rate of PC use has significantly increased from 0.64% in 2008 to 1.95% in 2014. Patients receiving PC had more co-comorbidities, posttransplantation complications, inpatient procedures, and were more likely to carry a diagnosis of leukemia. In allogeneic HSCT, large bed size (odds ratio [OR] =2.80; 95% confidence interval [CI]: 1.17-6.70), stem cell source from cord blood (OR = 1.93; 95% CI: 1.15-3.24), and graft-versus-host disease (OR = 2.04; 95% CI: 1.36-3.06) were predictors of PC use. In a subset analysis of 783 patients who died during hospitalization, 166 (21.20%) received PC. Among the decedents, Hispanic race had lower odds of PC use (OR = 0.20; 95% CI: 0.05-0.82) in allogeneic HSCT and women had higher odds of PC (OR = 2.70; 95% CI: 1.35-5.41) in autologous HSCT. Conclusions: The rate of PC use has significantly increased among patients undergoing HSCT during hospitalization from 2008 to 2014 but still remains very low. Further investigation is warranted to verify and better understand the barriers toward PC use for HSCT patients.

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“…One possibility is that the sometimes-single-minded focus on cure-oriented care of TSs can be the result of the acuity of the pathology they manage. 23,24 Several models for integration of palliative care in this setting have been detailed with an emphasis generally placed on a multidisciplinary approach. In our study, TSs responses did indicate an interest in conducting these conversations which was higher than the interest PCSs perceived them to have; however, TSs also rated their perceived interest of PCSs in goal setting as higher than their own, suggesting that they are open to integration of palliative care into care for the IGP, but may not have a construct they are comfortable with as of yet.…”

Section: Discussionmentioning

confidence: 99%

Trauma Surgeon and Palliative Care Physician Attitudes Regarding Goals-of-Care Delineation for Injured Geriatric Patients

Cunningham

Scielzo

Nakonezny

et al. 2019

Am J Hosp Palliat Care

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Background: The value of defining goals of care (GoC) for geriatric patients is well known to the palliative care community but is a newer concept for many trauma surgeons. Palliative care specialists and trauma surgeons were surveyed to elicit the specialties’ attitudes regarding (1) importance of GoC conversations for injured seniors; (2) confidence in their own specialty’s ability to conduct these conversations; and (3) confidence in the ability of the other specialty to do so. Methods: A 13-item survey was developed by the steering committee of a multicenter, palliative care-focused consortium and beta-tested by trauma surgeons and palliative care specialists unaffiliated with the consortium. The finalized instrument was electronically circulated to active physician members of the American Association for the Surgery of Trauma and American Academy for Hospice and Palliative Medicine. Results: Respondents included 118 trauma surgeons (8.8%) and 244 palliative care specialists (5.7%). Palliative physicians rated being more familiar with GoC, were more likely to report high-quality training in performing conversations, believed more palliative specialists were needed in intensive care units, and had more interest in conducting conversations relative to trauma surgeons. Both groups believed themselves to perform GoC discussions better than the other specialty perceived them to do so and favored their own specialty leading team discussions. Conclusions: Both groups believe themselves to conduct GoC discussions for injured seniors better than the other specialty perceived them to do so, which led to disparate views on the optimal leadership of these discussions.

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Optimizing End-of-Life Care for Patients With Hematological Malignancy: Rethinking the Role of Palliative Care Collaboration

Cited by 13 publications

References 10 publications

Palliative Care for a Mentally Incompetent End Stage Renal Failure Patient: Why Is It Important?

Palliative Care for a Mentally Incompetent End Stage Renal Failure Patient: Why Is It Important?

Utilization of Palliative Care for Patients Undergoing Hematopoietic Stem Cell Transplantation During Hospitalization: A Population-Based National Study

Trauma Surgeon and Palliative Care Physician Attitudes Regarding Goals-of-Care Delineation for Injured Geriatric Patients

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