Using Functional Status at the Time of Palliative Care Consult to Identify Opportunities for Earlier Referral

Area of Science:

• Palliative Care Medicine
• Geriatric Medicine
• Health Services Research

Background:

• Improving early access to palliative care is crucial for patient well-being.
• Real-time monitoring of palliative care referral practices is needed.
• Functional status at referral may indicate opportunities for earlier intervention.

Purpose of the Study:

• To evaluate differences in Australia-Modified Karnofsky Performance Status (AKPS) at initial palliative care consultation across various serious illnesses.
• To determine if AKPS can identify patients who could benefit from earlier palliative care referral.

Main Methods:

• Retrospective analysis of an inpatient palliative care consult registry.
• Classification of serious illnesses using ICD-10 codes.
• Assessment of AKPS by palliative care clinicians during initial consultations.

Main Results:

• Significant variation in AKPS distribution was observed among different serious illnesses (p < 0.001).
• Patients with cancer and heart disease generally presented with preserved functional status.
• A majority of patients with dementia, neurological, lung, liver, and renal diseases were bedbound upon initial palliative care consult.

Conclusions:

• Palliative care referral timing is associated with specific serious illnesses.
• AKPS measurement at referral provides valuable insights into patient functional status.
• Utilizing AKPS can aid in monitoring referral patterns and facilitating earlier palliative care access.