Outcome evaluation in a home palliative care service

Area of Science:

• Palliative Care Medicine
• Gerontology
• Quality of Life Research

Background:

• Assessing the impact of palliative care presents unique challenges due to limitations of traditional outcome indicators.
• Home-based palliative care units aim to improve patient quality of life and symptom management.

Purpose of the Study:

• To describe patient quality of life at the start and during home palliative care.
• To identify potential indicators for assessing the quality of palliative home care.
• To evaluate the effectiveness of palliative care interventions on symptom distress and quality of life.

Main Methods:

• A prospective study involving 73 patients receiving palliative home care.
• Utilized an Italian version of the Symptom Distress Scale to evaluate symptom distress.
• Monitored quality-of-life patterns over time, including pain, appetite, nausea, and psychological, social, and functional aspects.

Main Results:

• Palliative care demonstrated effectiveness in pain mitigation, appetite stimulation, nausea control, and psychological symptom management.
• Social and functional aspects of quality of life showed a consistent decline during the study period.
• Median survival in palliative home care was 29 days, with challenges including high data missingness and short treatment durations for some patients.

Conclusions:

• A "multiple outcomes approach" using diverse indicators is essential for a comprehensive evaluation of palliative care.
• Sole reliance on single assessment instruments is insufficient due to the complexity and variability of patient outcomes.
• Further research is needed to refine outcome indicators for home-based palliative care to better capture its multifaceted impact.