Treatment effects of palliative care consultation and patient contentment: A monocentric observational study

Medicine (Baltimore). 2021 Mar 26;100(12):e24320. doi: 10.1097/MD.0000000000024320.

Abstract

Palliative care is a central component of the therapy in terminally ill patients. During treatment in non-palliative departments this can be realized by consultation.To analyze the change in symptom burden during palliative care consultation.In this observational study, we enrolled all cancer cases (n = 163) receiving inpatient treatment for 2015 to 2018 at our institution. We used the MDASI-questionnaire (0 = 'not present' and 10 = "as bad as you can imagine") and the FAMCARE-6 (1 = very satisfied, 5 = very dissatisfied) to analyze the treatment effect and patient satisfaction, respectively.We examined the association of symptom burden and patient satisfaction using Spearman-correlation. Comparing mean values, we applied the Wilcoxon-test and one-way ANOVA.An improvement in MDASI-core-items after treatment completion was significant (P < .05) in 14/18 symptoms. The change in perception of pain showed the strongest improvement (median: 5 to 3). Initially the MDASI-items "activity" (median = 8) and emotional distress (median = 5 and 6) were viewed as especially incriminating. There was no evidence for a correlation between patients' age, the type of diagnosis and time since diagnosis.The analysis of FAMCARE-6 patient contentment was lower or equal to two in all of the six items. There was a weak negative association between the change in symptom burden of psycho-emotional items "distress/feeling upset" (P = .006, rSp = -0,226), "sadness" and patient satisfaction in FAMCARE-6.A considerable improvement of the extensive symptom burden particularly of pain relief was achieved by integrating palliative consultation in clinical practice.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cancer Pain / diagnosis
  • Cancer Pain / psychology
  • Cancer Pain / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / psychology
  • Neoplasms / therapy*
  • Pain Measurement / statistics & numerical data
  • Palliative Care / psychology*
  • Patient Reported Outcome Measures
  • Patient Satisfaction / statistics & numerical data*
  • Program Evaluation
  • Referral and Consultation / organization & administration*
  • Retrospective Studies
  • Terminally Ill / psychology
  • Terminally Ill / statistics & numerical data
  • Treatment Outcome