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Acute palliative care units: characteristics, activities and outcomes - scoping review
Sebastiano Mercadante1, Eduardo Bruera2
1Main regional center for pain relief and supportive/palliative care, La Maddalena Cancer center, Palermo, Italy terapiadeldolore@lamaddalenanet.it.
Abstract:
Acute palliative care units (APCUs) are lacking in most cancer hospitals and even when palliative care units are present, they are predominantly based on a traditional hospice-like model for patients with short life expectancy. This scoping review examined the papers assessing the activities of APCU. Data from literature regarding APCU characteristics, activities and outcomes have shown important differences among different countries.In comparison with existing data on traditional hospices, APCU provided a whole range of palliative care interventions, from an early treatment of pain and symptoms at time diagnosis and during the oncological treatment, up to the advanced stage of disease when they may favour the transition to the best supportive care or palliative care only, also indicating the best palliative care service that may fits the clinical and social condition of individuals. Large differences in the characteristics of such units, including hospital stay and mortality, have been evidenced, in some cases resembling those of a traditional hospice. It likely that in some countries such units supply the lack of other palliative care services.Further studies on APCUs are needed, even on other outcome processes, to provide a more precise identification among the palliative care settings, which should not interchangeable, but complimentary to offer the full range of activities to be activated according to the different needs of the patients.
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