A palliative medicine program in a community setting: 12 points from the first 12 months

Area of Science:

• Palliative Medicine
• Health Services Research
• Geriatric Medicine

Background:

• Integrated palliative medicine programs are crucial for managing complex patient needs in community hospitals.
• A comprehensive understanding of patient demographics, suffering, and consultation outcomes is essential for program optimization.

Purpose of the Study:

• To report the first year's experience of a consultative, interdisciplinary, integrated palliative medicine program.
• To analyze patient data, including demographics, reasons for consultation, symptom burden, and outcomes.
• To evaluate the program's recommendations and their impact on patient survival.

Main Methods:

• Prospective data collection on 308 consecutive consultations.
• Development and utilization of a computer database for comprehensive data analysis.
• Analysis of patient-reported outcomes, including symptom severity and suffering scales.

Main Results:

• Cancer was the most frequent diagnosis (34%), with pain as the primary reason for consultation (43%).
• Patients presented with a median of 5 acute and 3 chronic medical problems, taking a median of 10 medications.
• A median of 8 recommendations were made per consultation, with 84% involving medication changes; median survival post-consultation was 11 days.

Conclusions:

• The integrated palliative medicine program effectively addressed complex patient needs, with a strong focus on pain management.
• The program generated numerous recommendations, particularly medication adjustments, highlighting its active role in patient care.
• The data underscore the need for improved methods to capture longitudinal patient-reported outcomes in palliative care settings.