EOLP-07. A REAL-WORLD INTEGRATED OUTPATIENT PALLIATIVE AND SUPPORTIVE CARE CLINIC IN A REGIONAL COMMUNITY NEURO-ONCOLOGY PRACTICE

Abstract

Abstract BACKGROUND Palliative care (PC), a specialty focused on alleviating suffering, is appropriate at any stage of serious illness and can improve quality of life, survival and reduce care partner distress. Integration within the care of neuro-oncology (NOC) patients remains difficult. At our center, patients who might benefit from specialty palliative care have been seen by a dual fellowship trained NOC and PC specialist (A.S.) since February 2021. We present our experience here. METHODS This was a retrospective chart review including records from the electronic medical record system from February 2021 to May 2023. RESULTS/ CONCLUSION A total of 58 patients received integrated PC from 651 seen in the general NOC practice. The most common diagnosis was glioma (59%), with the rest being a mixture of lymphoma or systemic cancer with brain involvement. Majority of patients were male (53%) and identified as White/Caucasian (86%). The average age of patients at referral was 58. The most common focus was symptom management (40%), followed by guidance around decision-making (14%), care partner support (11%), advance care planning (10%), and support with coping (9%). The most common symptoms discussed included fatigue (36%), seizures (22%), and pain (21%). By the submission of this abstract, 28 (48%) patients had passed away, 22 of whom (79%) had formally enrolled on hospice with an average of 24 days prior to death. The primary cause of death was respiratory failure towards end of life (71%). Three patients (11%) had chosen to employ the California End of Life Act. Advanced directives were discussed and completed in 82% and a proxy had been identified in 100%. This model of integrated PC for NOC clinics appears to be feasible, meaningful and is welcomed for it allows focused, dedicated attention to symptom management, distress alleviation, advance care planning and hospice transition.