Continuous Ambulatory Delivery Device Use for Patients Managed by an Inpatient Palliative Care Team.

Area of Science:

• Palliative Care
• Oncology
• Pain Management

Background:

• Patient-Controlled Analgesia (PCA) using Continuous Ambulatory Delivery Devices (CADD) is crucial for managing pain and symptoms in hospitalized cancer patients.
• Limited studies exist on the specific indications and barriers for initiating CADDs in inpatients managed by palliative care teams.

Purpose of the Study:

• To retrospectively review indications for CADD initiation in palliative care consults.
• To explore the timing of CADD initiation and identify barriers to its use.
• To inform hospital policy regarding CADD accessibility.

Main Methods:

• A retrospective chart review of 61 adult patients requiring CADD for symptom control over six months.
• Data collected during daily inpatient palliative care consult rounds.
• Patient demographics captured using the team's database sheets.

Main Results:

• Primary indications for CADD initiation were lack of oral opioid efficacy and enhancing patient autonomy in pain management.
• Approximately 20% of patients needed unit transfers to accommodate CADD use.
• Median length of stay was 13 days; pumps were initiated within half a day.

Conclusions:

• The study identifies key indications for CADD use within palliative care.
• Inconsistent hospital access to CADDs due to varying departmental protocols can hinder optimal symptom management and patient safety.
• Revising hospital policy to broaden CADD access is recommended to improve patient outcomes and potentially reduce length of stay.