Feasibility Study of the care pathway checklist (CPCL) for palliative care interventions (PCIs) delivered by oncologists in routine care
Konferenzpapier/Poster - 18.05.2017
Mosoiu D., Achimas P., Domeisen Benedetti Franzisca, Rahnea G., Poroch V., Grigorescu A., Curca R., Schmidt Mary Helen, Magayakalbermatten N, Groza M., Strasser Florian
Name der Konferenz
Titel der Konferenzberichte
Background: Early specialized palliative care (sPC)
documents benefits in nord american settings, but in
ressource-variable european countries often lacking a SPC
workforce clinical practice tools (CPT) for oncology health care
professionals (O-HCPs) may be efficient to address cancer
patients (pts) unmet needs for PCIs.
Aim: to develop and test a CPT to screen for and deliver PCIs
Methods: Prospective 2-week multicenter feasibility study in
out-and inpatient units of consecutive pts (PS 1–3, normal
cognition, advanced incurable cancer).
Screening: 6 predefined questions on palliative needs, rESAS
Intervention: weekly needs-tailored and institution adapted
CPCL with defined 7 PCIs (illness/prognosis understanding,
symptom management, chemotherapy preference/decision,
family care, networking, end-of-life worries, spirituality).
Outcomes: rESAS change in 2 weeks (Paired-samples t-tests), relation of number of CPCL (0–7) and rESAS change (Binary
logistic regressions), specific CPCL and individual symptom
improvement (Pearson’s Chi-squared tests).
Results: In 81 pts (median age 59, 48.1% female) from 6
romanian centres pain (t76=2.68, p=.009), fatigue
(t76=3.40, p=.001), anxiety (t73=2.33, p=.023), depression
(t71=3.60, p=.001), dyspnea (t76=2.27, p=.026), appetite
(t76=3.30, p=.001) and somnolence (t76=2.29, p=.025)
were significantly reduced. Using more CPCL was a significant
predictor of improved mood. Improvement (all n=81) of pain
was associated with illness/ prognosis (Χ2=7.60, p=.006),
chemotherapy (Χ2=10.42, p=.001), and symptom
management (Χ2=6.24, p=.012) CPCL; of nausea (n=81) with
chemotherapy (Χ2=5.26, p=.022) CPLC, and of appetite with
symptom management (Χ2= 5.56, p=.018) CPCL.
Conclusion: The application of a pragmatic screening and
CPCL to deliver advanced cancer pts needs-based defined
PCIs seems feasible and effective for symptom control.
Further research may explore change of pts needs and a realworld