Symptoms in 400 patients referred to palliative care services: prevalence and patterns

Abstract

The demographics and prevalence of symptoms in patients at first referral to the different components of palliative care services were identified by a retrospective case note study of 400 patients referred to three palliative care centres in London, UK: Michael Sobell House, Mount Vernon Hospital; The North London Hospice; St Bartholomew's and the Royal London Hospitals. One hundred consecutive referrals to each of the following service components were analysed: a hospice inpatient service; a community team; an NHS hospital support team and an outpatient service. A standardized proforma was used to collect the data. Ninety five per cent (380/400) of patients referred had a cancer diagnosis. The five most prevalent symptoms overall were pain (64%), anorexia (34%), constipation (32%), weakness (32%) and dyspnoea (31%), which is similar to other published reports. However, the commonest symptoms and their prevalence varied depending on the service component to which the patient was referred. Patients referred to hospice and community services had the highest symptom burden (mean number of symptoms per patient 7.21 and 7.13, respectively). This study suggests that different patient subgroups may have different needs in terms of symptoms, which will be relevant for the planning and rationalization of palliative care services.

Validity, reliability and clinical feasibility of a Needs Assessment Tool for people with progressive cancer

“…However, this item encompassed potential physical symptoms including fatigue, pain, dyspnoea, loss of appetite, nausea, constipation, diarrhoea, drowsiness and sleep problems. It is possible that some health professionals considered a number of these symptoms in making their assessment, while others focussed predominately on pain, the most prevalent physical symptom reported by patients with advanced cancer [32][33][34][35][36][37][38][39]. Given the importance of accurate assessment of physical concerns, the results suggest a need for greater specificity in this item.…”

Charakteristika von Palliativpatienten mit Atemnot – Ergebnisse der Hospiz- und Palliativerhebungen (HOPE) von 2006 bis 2008

“…In der internationalen Literatur sind Schmerzen, Appetitlosigkeit, Übelkeit, Obstipation, Schwäche und Atemnot häufige Symptome von Palliativpatienten (Potter et al 2003, Radbruch et al 2003, Borgsteede et al 2007 Palliativmedizin nachhaltig geprägt (Klaschik 2009, Radbruch et al 1997 , Krumm et al 2008). …”

Diagnosis of Depression in Patients Receiving Specialist Community Palliative Care: Does Using a Single Screening Question Identify Depression Otherwise Diagnosed by Clinical Interview?

“…The patients were representative, in terms of age and diagnosis, of those referred to the local community team and to national palliative care services. 12 However, it is possible that due to the small sample size, the study underestimates the prevalence of depression and hence the sensitivity and specificity of the single question.…”