Cuidados paliativos en hematología clínica: experiencia de una consulta integrativa en pacientes con mieloma múltiple

Abstract

AimTo describe the experience after the first year of operation of an integrative palliative care clinic for patients with multiple myeloma. Materials and methodsThe medical records were reviewed of patients seen for the first time in the integrative palliative care clinic for patients with multiple myeloma. During the first, and the next 3 visits, pain, anorexia, constipation, insomnia, nausea and vomiting, dyspnoea, anxiety, and sadness were evaluated using a visual numeric scale [0-10]. The symptomatic burden of physical and emotional symptoms was calculated by summing the scores of their visual numeric scale. The pain intensity and its interference were assessed using the Spanish version of the Brief Pain Inventory modified ad hoc. ResultsFrom February to December 2013, 67 patients (median 355 days from diagnosis) were seen, and after 3 follow up visits (median 60 days from the first visit) the proportion of patients with moderate-severe pain (visual numeric scale≥5) was reduced for “worst pain” (57% vs. 18%; P<.0001) and “average pain” (24% vs. 2%; P<.0001). The proportion of patients without interference from pain improved in, general activity (52% vs. 82%; P=.0001), sleep (73% vs. 91%; P=.01), and mood (52% vs. 87.5%; P=.0001). There was also improvement in the physical and emotional symptom burden, and the proportion of depressed patients (13% vs. 5%; P=.001). ConclusionsThe integration of palliative care in the care of patients with multiple myeloma is not only possible, but also significantly improves the emotional and physical symptoms.