Patients assisted by the palliative care center in a university hospital

Authors

DOI:

https://doi.org/10.33448/rsd-v12i5.41541

Keywords:

Palliative care; Supportive palliative care; Comfort care.

Abstract

Objective: The present study aimed to evaluate the clinical and epidemiological profile of patients referred to the palliative care service of a university hospital. Methods: A retrospective cohort study involved 138 patients in need of palliative care, aged between 4 months and 95 years, hospitalized from January 2020 to August 2021. Demographic, clinical, biochemical, radiological data and results were collected from medical records of patients. Results: According to the data analyzed during hospitalization, the average age is 65.89 years, with about 3 diagnoses or different clinical conditions. The most prevalent comorbidities were systemic arterial hypertension (82.61%) followed by neoplasms (79.71%). As for the outcome, most admitted patients died during hospitalization (71.54%). The time between hospital admission and admission to palliative care was shorter among cancer patients. A longer hospital stay and admission to palliative care was observed among patients with higher initial investments by the medical team. Conclusion: Palliative care is still mistakenly seen as end-of-life care. Detailed patient assessment and knowledge of the characteristics of patients who should be referred to palliative care help in the development of strategies to improve the service. The present study seeks to contribute to the modification of the end-of-life palliative care assistance profile.

References

Agar, M. R., Lawlor, P. G., Quinn, S., Draper, B., Caplan, G. A., Rowett, D., Sanderson, C., Hardy, J., Le, B., Eckermann, S., McCaffrey, N., Devilee, L., Fazekas, B., Hill, M., Currow, D. C. (2017). Efficacy of Oral Risperidone, Haloperidol, or Placebo for Symptoms of Delirium Among Patients in Palliative Care: A Randomized Clinical Trial. JAMA Intern Med ;177(1):34-42.

Barroso-Sousa, R., Barry, W. T., Garrido-Castro, A. C., Hodi, F. S., Min, L., Krop, I. E. & Tolaney, S. M. (2018). Incidence of Endocrine Dysfunction Following the Use of Different Immune Checkpoint Inhibitor Regimens: A Systematic Review and Meta-analysis. JAMA Oncol ;4(2):173-182. 10.1001/jamaoncol.2017.3064.

Beck, M., Wanchai, A., Stewart, B. R., Cormier, J. N. & Armer, J. M. (2012). Palliative care for cancer-related lymphedema: a systematic review. J Palliat Med; 15(7):821-7. 10.1089/jpm.2011.0494.

Bekelman, D. B., Plomondon, M. E., Carey, E. P., Sullivan, M. D., Nelson, K. M., Hattler, B., McBryde, C. F., Lehmann, K. G., Gianola, K., Heidenreich, P. A. & Rumsfeld, J. S. (2015). Primary Results of the Patient-Centered Disease Management (PCDM) for Heart Failure Study: A Randomized Clinical Trial. JAMA Intern Med;175(5):725-32. 10.1001/jamainternmed.2015.0315.

Braun, L. T., Grady, K. L., Kutner, J. S., et al. (2016). Palliative Care and Cardiovascular Disease and Stroke: A Policy Statement From the American Heart Association/American Stroke Association. Circulation; 134:e 198.

Bruera, E. (2021). Overiew of managing common non-pain symptoms in palliative care. UpToDate. https://www.uptodate.com/contents/overview-of-managing-common-non-pain-symptoms-in-palliative-care?search=palliative%20care&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2.

Costa, J. C., Barbosa, A. M. & Zandonade, E. (2021). Caracterização dos pacientes acompanhados pelo serviço de Cuidados Paliativos de um hospital universitário. RBPS [Internet];22(2):18-2. https://periodicos.ufes.br/rbps/article/view/27810

Delgado-Guay, M. O., Chisholm, G., Williams, J., Frisbee-Hume, S., Ferguson, A. O. & Bruera, E. (2016). Frequency, intensity, and correlates of spiritual pain in advanced cancer patients assessed in a supportive/palliative care clinic. Palliat Support Care;14(4):341-8. 10.1017/S147895151500108X.

Epstein, A. S., Prigerson, H. G., O'Reilly, E. M. & Maciejewski, P. K. (2016). Discussions of Life Expectancy and Changes in Illness Understanding in Patients With Advanced Cancer. J Clin Oncol; 34(20):2398-403. 10.1200/JCO.2015.63.6696.

Fang, J. C., Ewald, G. A., Allen, L. A., Butler, J., Westlake, C. C. A., Colvin-Adams, M., Dickinson, M. G., Levy, P., Stough, W. G., Sweitzer, N. K., Teerlink, J. R., Whellan, D. J., Albert, N. M., Krishnamani, R., Rich, M. W,, Walsh, M. N., Bonnell, M. R., Carson, P. E., Chan, M. C., Dries, D. L., Hernandez, A. F., Hershberger, R. E., Katz, S. D., Moore, S., Rodgers, J. E., Rogers, J. G., Vest, A. R. & Givertz, M. M. Heart Failure Society of America Guidelines Committee. (2015). Advanced (stage D) heart failure: a statement from the Heart Failure Society of America Guidelines Committee. J Card Fail;21(6):519-34. 10.1016/j.cardfail.2015.04.013.

Ferrell, B. R., Temel, J. S., Temin, S., Alesi, E. R., Balboni, T. A., Basch, E. M., Firnm J. I., Paice, J. A., Peppercorn, J. M., Phillips, T., Stovall, E. L., Zimmermann, C. & Smith, T. J. (2017). Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol. Jan;35(1):96-112. 10.1200/JCO.2016.70.1474.

Leung, D. Y. P. & Chan, H. Y. L. (2020). Palliative and End-of-Life Care: More Work is Required. International Journal of Environmental Research and Public Health; 17(20):7429. https://doi.org/10.3390/ijerph17207429

Meier, D. & McCormick, E. (2021). Benefits, services, and models of subspecialty palliative care. UpToDate. https://www.uptodate.com/contents/benefits-services-and-models-of-subspecialty-palliative-care?search=palliative%20care&source=search_result&selectedTitle=8~150&usage_type=default&display_rank=8

Morrison, R. S. & Meier, D. E. (2004). Clinical practice. Palliative care. N Engl J Med. 350(25):2582-90. 10.1056/NEJMcp035232.

Okon, T. & Christensen, A. (2021). Oreview of comprehensive patient assessment in palliative care. UpToDate. https://www.uptodate.com/contents/overview-of-comprehensive-patient-assessment-in-palliative-care?search=palliative%20care&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1.

Organização Mundial da Saúde (OMS). (2020). Palliative Care.

P Goddu, A., O'Conor, K. J., Lanzkron, S., Saheed, M. O., Saha, S., Peek, M. E., Haywood, C. J. & Beach, M. C. (2018). Do Words Matter? Stigmatizing Language and the Transmission of Bias in the Medical Record. J Gen Intern Med; 33(5):685-691. 10.1007/s11606-017-4289-2. Erratum in: J Gen Intern Med. 34(1):164.

Peuckmann, V., Elsner, F., Krumm, N., Trottenberg, P. & Radbruch, L. (2010). Pharmacological treatments for fatigue associated with palliative care. Cochrane Database Syst Rev; (11):CD006788. 10.1002/14651858.CD006788.pub2.

Quest, T. & Lamba S. (2021). Palliative care for adults in the emergency department. UpToDate. https://www.uptodate.com/contents/palliative-care-for-adults-in-the-emergency-departmented?search=Palliative%20Performance%20Scale%20(PPS)&source=search_result&selectedTitle=6~21&usage_type=default&display_rank=6.

Robinson, S., Kissane, D. W., Brooker, J. & Burney, S. (2016). A Review of the Construct of Demoralization: History, Definitions, and Future Directions for Palliative Care. Am J Hosp Palliat Care; 33(1):93-101. 10.1177/1049909114553461.

Sedhom, R., MacNabb, L., Smith, T. J., Yabroff, K. R. (2021). How palliative care teams can mitigate financial toxicity in cancer care. Support Care Cancer; 29(11):6175-6177. 10.1007/s00520-021-06288-5.

Sidebottom, A. C., Jorgenson, A., Richards, H., Kirven, J. & Sillah, A. (2015). Inpatient palliative care for patients with acute heart failure: outcomes from a randomized trial. J Palliat Med;18(2):134–142.

Smith, T. J., Dow, L. A., Virago, E. A., Khatcheressian, J., Matsuyama, R. & Lyckholm, L. J. (2011). A pilot trial of decision aids to give truthful prognostic and treatment information to chemotherapy patients with advanced cancer. J Support Oncol; 9(2):79-86. 10.1016/j.suponc.2010.12.005.

Townsend, K. (2018). Demoralisation in palliative care. Lancet Oncol;19(2):168. 10.1016/S1470-2045(18)30020-2.

Urgate, O., Rocha, P. & Paula, L. (2014). Contexto normativo dos cuidados paliativos no SUS. Creative Commons License. https://lume.ufrgs.br/ handle/10183/114783.

Wong, F. K., Ng, A. Y., Lee, P. H., Lam, P. T., Ng, J. S., Ng, N. H. & Sham, M. M. (2016). Effects of a transitional palliative care model on patients with end-stage heart failure: a randomised controlled trial. Heart; 15;102(14):1100-8. 10.1136/heartjnl-2015-308638.

Downloads

Published

18/05/2023

How to Cite

BARBOSA, G. S. .; BARBOSA , D. S. .; FAVERO, G. de M. .; AOKI, N. K. .; ZUNTINI, V. N. .; LORO, F. R. .; SANTOS , T. F. dos .; RIGO , R. S. . Patients assisted by the palliative care center in a university hospital. Research, Society and Development, [S. l.], v. 12, n. 5, p. e19112541541, 2023. DOI: 10.33448/rsd-v12i5.41541. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/41541. Acesso em: 27 apr. 2024.

Issue

Vol. 12 No. 5

Section

Health Sciences

License

Copyright (c) 2023 Gabriel Sonchini Barbosa; Daniel Sonchini Barbosa ; Guilherme de Moraes Favero; Natalia Keiko Aoki; Vinicius Nogueira Zuntini; Felipe Rossi Loro; Tauanne Fernanda dos Santos ; Rosângela Silva Rigo

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.