Palliative care models for patients living with advanced cancer: a narrative review for the emergency department clinician

Abstract

Eighty-one percent of persons living with cancer have an emergency department (ED) visit within the last 6 months of life. Many cancer patients in the ED are at an advanced stage with high symptom burden and complex needs, and over half is admitted to an inpatient setting. Innovative models of care have been developed to provide high quality, ambulatory, and home-based care to persons living with serious, life-limiting illness, such as advanced cancer. New care models can be divided into a number of categories based on either prognosis (e.g., greater than or less than 6 months), or level of care (e.g., lower versus higher intensity needs, such as intravenous pain/nausea medication or frequent monitoring), and goals of care (e.g., cancer-directed treatment versus symptom-focused care only). We performed a narrative review to (1) compare models of care for seriously ill cancer patients in the ED and (2) examine factors that may hasten or impede wider dissemination of these models.

Identifying emergency department patients with life‐limiting illnesses may be getting a little easier

“…One barrier is the lack of pragmatic screening tools for identifying patients with life‐limiting illnesses that are validated for the ED setting. Additionally, ED clinicians often care for 20–30 new undifferentiated patients per shift and may lack the time to use a screening tool 4 . Finally, the need to provide immediate life‐saving interventions may also prevent ED clinicians from initiating goals of care conversations and addressing unmet palliative care needs due to underlying life‐limiting illnesses.…”

The effectiveness of progressive muscle relaxation technique in reducing cancer-related pain among palliative care patients: A randomized controlled trial

“…7,8 The specific composition of the team may vary depending on the healthcare setting and the needs of the patient. 9 However, collaboration and coordination among these professionals are crucial in delivering comprehensive and holistic palliative care to patients. 7 In Jordan, palliative care services have been introduced and integrated into healthcare systems in recent years.…”