Abstract
BackgroundTo support the early integration of palliative home care (PHC) in cancer treatment, we developed the EPHECT intervention and pilot tested it with 30 advanced cancer patients in Belgium using a pre post design with no control group. We aim to determine the feasibility, acceptability and perceived effectiveness of the EPHECT intervention.MethodsInterviews with patients (n = 16 of which 11 dyadic with family caregivers), oncologists and GPs (n = 11) and a focus group with the PHC team. We further analyzed the study materials and logbooks of the PHC team (n = 8). Preliminary effectiveness was assessed with questionnaires EORTC QLQ C-30, HADS and FAMCARE and were filled in at baseline and 12, 18 and 24 weeks.ResultsIn the interviews after the intervention period, patients reported feelings of safety and control and an optimized quality of life. The PHC team could focus on more than symptom management because they were introduced earlier in the trajectory of the patient. Telephone-based contact appeared to be insufficient to support interprofessional collaboration. Furthermore, some family caregivers reported that the nurse of the PHC team was focused little on them.ConclusionNurses of PHC teams are able to deliver early palliative care to advanced cancer patients. However, more attention needs to be given to family caregivers as caregiver and client. Furthermore, the home visits by the PHC team have to be further evaluated and adapted. Lastly, professionals have to find a more efficient way to discuss future care.
Highlights
To support the early integration of palliative home care (PHC) in cancer treatment, we developed the EPHECT intervention and pilot tested it with 30 advanced cancer patients in Belgium using a pre post design with no control group
To facilitate the early integration of palliative home care in cancer treatment, we developed the Early Palliative Home Care Embedded in Cancer Treatment intervention (Table 1) [13]
Main findings This study shows that early integration of palliative home care in oncology treatment is feasible and accepted for the most part by patients, family caregivers and professional caregivers
Summary
To support the early integration of palliative home care (PHC) in cancer treatment, we developed the EPHECT intervention and pilot tested it with 30 advanced cancer patients in Belgium using a pre post design with no control group. The World Health Organization (WHO) advises to provide palliative care early in the course of a lifethreatening illness – i.e. from diagnosis of advanced cancer on –, in conjunction with other therapies that are intended to prolong life [1]. Most studies showed a positive effect, but all focused on integrating early palliative care in cancer treatment in the hospital or in the outpatient setting. No studies have been published on integrating palliative care early at home. Palliative care is provided in hospitals or via outpatient clinics and and especially at home. A recent systematic literature review shows that the majority of cancer patients prefers to die in their own homes [11] and palliative home care allows people to stay at home until death, supported and surrounded by those close to them [12]
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