Palliative care impact on symptom burden.

Abstract

217 Background: A national network of five hospitals piloted the use of a patient reported outcomes tool as a means for referring patients to the palliative care program. An externally validated assessment tool that captures patients’ perceived symptom burden from baseline and every 21 days was used as means of identifying patients who might benefit from referral if they met the following criteria: six or > symptoms from 27 increasing in severity by two points or > since their last assessment and determined as having any stage cancer with metastatic disease, stage 3 not in remission, or stage 4 and not already enrolled in palliative care. The data generated from the pre and post referral assessments to the palliative care program was then used to measure the impact of the program on symptom burden for this group versus those patients referred to palliative care but electing not to engage. Methods: The patient population, identified as patients who took the assessment during a selected three-month period, was reviewed to identify two groups: those who were referred through the SIT process and subsequently joined the palliative care program, and those who were referred to palliative care but chose not to attend the appointment. Results were then reviewed for both groups for a six-month period, comparing the scores from the patients’ initial assessment and their subsequent assessment. The data from both groups was compared to identify changes in scores by symptom and overall average symptom scores and the cohorts reviewed for similarities and differences (age, gender, cancer type). Results: Out of the 27 symptoms the cohort electing to utilize palliative care had higher pre-referral scores than the comparison group; and their symptoms improved at a rate greater than those not seeking palliative care. The symptoms in which the greatest impact was experienced included: activity, appetite, drowsiness, sense of family, hope, mood, and sexual interest. Conclusions: Interventions from the Palliative Care program had a positive impact on symptom burden in comparison to the group that was referred for services but did not enter the program.