Palliative care team consultation and quality of death and dying in a university hospital: A secondary analysis of a prospective study

PLoS One. 2018 Aug 23;13(8):e0201191. doi: 10.1371/journal.pone.0201191. eCollection 2018.

Abstract

Purpose: Involvement of palliative care experts improves the quality of life and satisfaction with care of patients who are in the last stage of life. However, little is known about the relation between palliative care expert involvement and quality of dying (QOD) in the hospital. We studied the association between palliative care team (PCT) consultation and QOD in the hospital as experienced by relatives.

Methods: We conducted a secondary analysis of data from a prospective study among relatives of patients who died from cancer in a university hospital and compared characteristics and QOD of patients for whom the PCT was or was not consulted.

Results: 175 out of 343 (51%) relatives responded to the questionnaire. In multivariable linear regression PCT was associated with a 1.0 point better QOD (95% CI 0.07-1.96). In most of the subdomains of QOD, we found a non-significant trend towards a more favorable outcome for patients for whom the PCT was consulted. Patients for whom the PCT was consulted had more often discussed their preferences for medical treatment, had more often been aware of their imminent death and had more often been at peace with their imminent death. Further, patients for whom the PCT was consulted and their relatives had more often been able to say goodbye. Relatives had also more often been present at the moment of death when a PCT had been consulted.

Conclusion: For patients dying in the hospital, palliative care consultation is associated with a favorable QOD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Attitude to Death
  • Death
  • Family / psychology
  • Female
  • Hospitals, University
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / psychology
  • Neoplasms / therapy
  • Netherlands
  • Palliative Care / methods*
  • Prospective Studies
  • Quality of Life / psychology
  • Referral and Consultation
  • Surveys and Questionnaires
  • Terminal Care / methods

Grants and funding

This study was financially supported by grants from the Erasmus MC Medical Research Committee (grant number 2007-7208 to FEW) and the Tom and Josephine Rijckes Legacy Foundation to FEW; neither had any involvement in the study or publication. The study was conducted independent from the funders. All authors have full access to all the data (including statistical reports and tables) in the study and take responsibility for the integrity of the data and the accuracy of the analysis.