Abstract
BackgroundPatients with an advanced incurable disease are often hospitalised for some time during the last phase of life. Care in hospitals is generally focussed at curing disease and prolonging life and may therefore not in all cases adequately address the needs of such patients. We present the COMPASS study, a study on the effects and costs of consultation teams for palliative care in hospitals.This observational study aims to investigate the use, effects and costs of PCT consultation services for hospitalized patients with incurable cancer in the Netherlands.Methods/designThe study consists of 3 parts:1. A questionnaire, interviews and a focus group discussion to investigate the characteristics of PCT consultation in 12 hospitals. PCTs will register their activities to calculate the costs of PCT consultation.2. Cancer patients for whom the attending physician would not be surprised that they would die within 12 month will be included in a medical file search in three hospitals. Medical records will be investigated to compare care, treatment and hospital costs between patients with and patients without PCT consultation.3. In the other nine hospitals, we will perform a longitudinal study, and compare quality of life between 100 patients for whom a PCT was consulted with 200 patients without PCT consultation. Propensity score matching will be used to adjust for differences between both patient groups. Patients will be followed for three months after inclusion. Quality of life will be assessed with the Palliative Outcome Scale, the EuroQol-5d and the EORTC-QLQ-C15 PAL. Satisfaction with care in the hospital is measured with the IN-PATSAT32. The cost impact of PCT consultation will also be explored.DiscussionThis is the first multicenter study on PCT consultation in the Netherlands. The study will give valuable insight in the process, effects and costs of PCT consultation in hospitals. It is anticipated that PCT consultation has a positive effect on patients’ quality of life and satisfaction with care and will lead to less hospital care costs.
Highlights
Patients with an advanced incurable disease are often hospitalised for some time during the last phase of life
In the other nine hospitals, we will perform a longitudinal study, and compare quality of life between 100 patients for whom a Palliative Care Team (PCT) was consulted with 200 patients without PCT consultation
1. assess the characteristics of PCT consultation services in different hospitals, 2. study whether PCT consultation for patients with incurable cancer has an effect on in-hospital medical care, 3. explore whether PCT consultation for patients with incurable cancer has beneficial effects on patients’ quality of life and satisfaction with care and
Summary
Patients with an advanced incurable disease are often hospitalised for some time during the last phase of life. Care in hospitals is generally focussed at curing disease and prolonging life and may not in all cases adequately address the needs of such patients. Palliative care is provided at the end of life, and in earlier stages, sometimes alongside disease-directed interventions that are aimed at curing disease or prolonging life [8]. Basic palliative care, such as basic symptom management and supporting patients to align their treatment choices with their values and goals, should be delivered by any health professional attending patients in the last phase of life. More complex forms of care, such as managing refractory symptoms or negotiating a difficult family meeting, may require involvement of specialized palliative care professionals [8]
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