Palliative care consultation team: symptom relief in first 48 hours of hospitalization

Magda Aparecida Dos Santos Silva,Cibele Andrucioli De Mattos-Pimenta,Toshio Chiba,Ricardo Tavares De Carvalho,Marcio Augusto Diniz

doi:10.1590/0034-7167-2019-0391

Magda Aparecida Dos Santos Silva, Cibele Andrucioli De Mattos-Pimenta + Show 3 more

Open Access

https://doi.org/10.1590/0034-7167-2019-0391

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Abstract

To compare the relief of symptoms provided by palliative care consultation team (PCCT) compared to the traditional care team (TC), in patients with advanced cancer in the first 48 hours of hospitalization. Allocated to PCCT Group and TC Group, this study assessed 290 patients according to the Edmonton Symptom Assessment System (ESAS) within the first 48 hours of hospitalization. The main outcome was a minimum 2-point reduction in symptom intensity. At 48 hours, the PCCT Group had a 2-point reduction in the mean differences (p <0.001) in pain, nausea, dyspnea, and depression; and TC Group, on nausea and sleep impairment (p <0.001). Multiple Logistic Regression found for the PCCT Group a greater chance of pain relief (OR 2.34; CI 1.01-5.43; p = 0.049). There was superiority of the PCCT Group for pain relief, dyspnea and depression. There is a need for more studies that broaden the understanding of team modalities.

Highlights

OBJECTIVECancer patients, especially at an advanced stage of the disease, have multiple symptoms that deteriorate functionality and negatively impact their quality of life
The hypothesis that patients treated by the Palliative Care Consultation Team (PCCT) would have better symptom control was partially confirmed
Multiple Logistic Regression showed that the palliative care consultation team (PCCT) Group had a 2.34 times higher odds of pain relief compared to the TC Group

Summary

Introduction

OBJECTIVECancer patients, especially at an advanced stage of the disease, have multiple symptoms that deteriorate functionality and negatively impact their quality of life. The management of symptoms in palliative care in oncology is complex and requires the action of prepared teams. In the last month of life, 66% of patients come to the hospital for acute management, 25% report feeling safer in hospitalization[3]; and in about 70% of them, the gateway is the emergency room[1]. Humanized assistance to these patients demands effective and fast control of symptoms, considering their fragility and short life expectancy, besides the fact that several of these symptoms are susceptible to control rapidly. Few studies have compared the effectiveness of care provided by palliative care teams to palliative care consultation team and traditional care teams in the hospital setting . [6,7]

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