Identifying palliative care needs in a Portuguese liver unit
Joana Rita Carvalho1, Mariana Vasconcelos1, Pedro Marques da Costa1
1Department of Gastroenterology and Hepatology, North Lisbon Hospital Centre, University of Lisbon, Lisbon, Portugal.
Summary
The NECPAL CCOMS-ICO© tool effectively identifies palliative care needs in chronic liver disease patients. This study highlights a significant gap between identified needs and actual palliative care referrals, emphasizing the tool
Area of Science:
- Hepatology
- Palliative Care Medicine
- Health Services Research
Background:
- Chronic liver disease is a leading global cause of illness and death.
- Established palliative care policies for chronic liver disease are lacking.
- The NECPAL CCOMS-ICO© tool aids in identifying palliative care needs, including for liver disease patients.
Purpose of the Study:
- To identify palliative care needs among patients hospitalized with liver disease in a specialized tertiary referral unit.
- To evaluate the utility of the NECPAL CCOMS-ICO© tool in this patient population.
Main Methods:
- A single-center prospective observational study was conducted.
- One hundred and twenty patients diagnosed with cirrhosis were enrolled.
- The NECPAL CCOMS-ICO© questionnaire was administered to all participants over a seven-month period.
Main Results:
- 84.2% of patients were identified as requiring palliative intervention.
- Clinicians identified these needs in only 65.8% of cases, and caregivers in 6.7%.
- Less than 8% of patients were referred for palliative care consultation.
- Excessive healthcare resource utilization strongly correlated with identified palliative care needs (OR 7.305, P < .001).
- Excessive healthcare facility use demonstrated 84.2% sensitivity and 42.1% specificity for predicting positive NECPAL results (AUC 0.710, P = .004).
Conclusions:
- The NECPAL CCOMS-ICO© tool is a practical and user-friendly instrument for assessing palliative care requirements in chronic liver disease.
- A significant disparity exists between identified palliative care needs and actual referrals, indicating a potential gap in care delivery.
- Excessive healthcare resource use may serve as an indicator for unmet palliative care needs.
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