A Descriptive Study On The Introduction of a Palliative Care Unit at an Oncological Facility in the Caribbean

Abstract

BACKGROUND: Palliative care is a currently undeveloped area with close affiliation to oncology, and its importance is often understated. Early integration is essential but limited in developing countries. OBJECTIVES: To outline unmet needs and emphasize benefits derived from the introduction of a palliative care unit at the main Oncology facility in the country. METHODS: Patient records from the palliative care unit during six months were retrieved manually. Patients needed to have a confirmed malignancy and advanced-stage disease to be included in the review. RESULTS: A total of 73 patients resulted in 162 visits. Gastrointestinal malignancies required the most input. Patients were predominantly female (58%), and the median age was 68 years. Most patients were referred late (more than eight weeks) after diagnosis of advanced-stage disease, with an Eastern Cooperative Oncology Group (ECOG) of three or more, and had a prognosis of fewer than three months. The median number of visits per patient was two, while the mode was one. Only 9.3% of patients required hospital admission. The majority of patients (72.6%) were referred after all treatment options were exhausted, and referrals from the palliative care unit were most commonly for hospice support. CONCLUSION: This introductory experience with a palliative unit outlined key areas for improvement. These included the need for earlier referrals to aid in the timely initiation of interventions addressing end of life care decisions. This has the potential to reduce the financial and low human resource burdens faced by our healthcare system.