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A new palliative care consultation team at the oncology department of a university hospital: an assessment of initial efficiency and effectiveness

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Abstract

Purpose

Palliative care consultation teams (PCCT) in acute hospitals have increased in number over recent years. To assess whether these teams are both efficient in their role within a palliative care centre and effective in the care that is provided for patients, we reviewed the initial activity of a new PCCT at the Oncology Department of Clínica Universidad de Navarra, a European Society for Medical Oncology-designated centre of integrated oncology and palliative care.

Methods

All patients evaluated by the PCCT over the first 3 years of its activity were included. Data about diagnosis, demographic characteristics, survival and initial symptom burden were evaluated using the Edmonton Symptom Assessment System (ESAS); whenever possible, a follow-up ESAS for inpatients was collected within 1 week from the electronic charts and analysed retrospectively.

Results

The PCCT evaluated 611 cancer patients within the initial 3 years of the service commencing. On the first visit, 392 patients (64 %) completed the ESAS evaluation. Of those that completed the ESAS, 43 % were outpatients, 52 % had gastrointestinal tumours, and 16 % died within a month. The evaluated patients had an average of six uncontrolled symptoms (≥4/10). The most common moderate to severe symptoms were fatigue (80 %), anorexia (67 %) and depression (62 %); 70 % of patients presented with pain (14 % with severe pain). Of the 225 inpatients evaluated, 110 (49 %) completed the follow-up ESAS within 1 week. A statistically significant decrease was observed for pain, nausea, depression, anxiety and somnolence as well as in the number of uncontrolled symptoms and in the symptom distress score. The patient's perception of his/her general well-being was better as meassured with the specific question of ESAS.

Conclusion

From the initial stages, the PCCT was both efficient in its role within the palliative care centre and effective in the care that was provided for patients. A significant number of patients were evaluated, many of them with severe symptoms and/or at the end of life. Inpatients receiving care from the PCCT experienced an improvement in symptom control within just a few days.

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Acknowledgments

This work was supported by a national grant from Institute of Health Carlos III [grant number FIS PI05/2428].

Conflict of interest

The authors declare no conflict of interest and disclosures.

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Authors and Affiliations

  1. Department of Palliative Care, Hospital Centro de Cuidados Laguna, Calle Concejal Francisco José Jiménez Martín, 128, Madrid, 28047, Spain

    Ana de Santiago

  2. Department of Palliative Medicine, Clínica Universidad de Navarra, Avenida Pío XII, 36, 31008, Pamplona, Navarra, Spain

    María Angustias Portela, Ana Larumbe, Julia Urdiroz, Marina Martínez & Carlos Centeno

  3. Department of Radiation Oncology, Clínica Universidad de Navarra, Pamplona, Spain

    Luis Ramos

  4. Department of Medical Oncology, Clínica Universidad de Navarra, Pamplona, Spain

    Jesús García-Foncillas

Authors
  1. Ana de Santiago
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  2. María Angustias Portela
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  3. Luis Ramos
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  4. Ana Larumbe
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  5. Julia Urdiroz
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  6. Marina Martínez
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  7. Jesús García-Foncillas
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  8. Carlos Centeno
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Corresponding author

Correspondence to Carlos Centeno.

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The authors have full control of all primary data and they agree to allow the journal to review their data if requested.

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de Santiago, A., Portela, M.A., Ramos, L. et al. A new palliative care consultation team at the oncology department of a university hospital: an assessment of initial efficiency and effectiveness. Support Care Cancer 20, 2199–2203 (2012). https://doi.org/10.1007/s00520-012-1476-x

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  • DOI: https://doi.org/10.1007/s00520-012-1476-x

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