Abstract
Integration of care between palliative care and oncology can improve patient outcomes and is increasingly recommended. Enhanced supportive care (ESC), led and delivered by palliative care clinical nurse specialists, is a potential model to achieve this but evidence about it is lacking. This research aimed to evaluate a nurse-led integrated ESC model within hepatopancreatobiliary cancer care. Some 101 patients with hepatopancreatobiliary cancer were supported by integrated ESC delivered in a co-located clinic. Data on symptoms and quality of life were collected prospectively. Survival data and chemotherapy use were retrospectively analysed following minimum follow-up, using a matched control technique. Patients receiving ESC exhibited less severe symptoms and better mood over time. They also had less aggressive treatment towards the end of life, receiving 31% less chemotherapy than controls with comparable survival. An integrated, nurse-led ESC model can be effective in improving outcomes for patients with hepatopancreatobiliary cancer.
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