Timely integration of palliative care. the reality check. a retrospective analysis

Abstract

PurposeA large volume of literature suggests that timely integration of palliative care (PC) enhances the well-being, quality of life and satisfaction of patients and their families. It may also positively impact clinical outcomes and healthcare costs throughout the disease trajectory. Therefore, reviewing clinical practice to reflect real-life situations regarding timely PC integration is essential.MethodsThis study, conducted at the Vienna General Hospital between March 2016 and August 2022, retrospectively examined PC consultation (PCC) requests. It aimed to assess the timeliness of PC integration by analysing the duration between diagnosis and the first PCC request, as well as the interval between the first PCC request and death.ResultsThis study included 895 PCCs. The median time from diagnosis to the first PCC was 16.6 (interquartile range (IQR): 3.9–48.4) months, while the median time from the first PCC to death was 17.2 (IQR: 6.1–50.7) days. The median time from diagnosis to first PCC was 10.4 months in females (confidence interval (CI): 6.0–14.8) compared to 10.6 months in males (CI: 8.1–13.1; p = 0.675). There were no gender disparities in the time from first PCC to death, with a median of 23.3 days (CI: 15.6–31.0) for females and 22.3 days (CI: 16.2–28.4) for males (p = 0.93). Fifty percent of patients died between 5 and 47 days after the first PCC.ConclusionThese findings highlight the discrepancy between the clinical perception of PC as end-of-life care and the existing literature, thereby emphasising the importance of timely PC integration.