Objectives: To describe the population of a palliative care day hospital (PCDH) in oncology and analyse the end-of-life trajectory.
Methods: Monocentric retrospective cohort study of all referred patients for the first time to PCDH over an 8-month period with the data collected in all PCDH in their pathway care.
Results: 116 patients were included for 319 stays in PCDH. At first referral PCDH, 62 (53.4%) patients had ongoing anticancer therapy. Twenty-four (20.7%) and 63 (54.3%) patients were in an unstable and deteriorating phase, respectively. Mean (SD) Eastern Cooperative Oncology Group performance status score was 2.8 (0.7). Mean (SD) stay per patient was 2.8 (2.2). For all stays, mean (SD) of joint intervention of palliative care team and oncologist was 1.2 (1.2) per patient. Mean (SD) of technical acts performed was 0.2 (0.6) per patient. Among the 109 deceased patients, 16 patients (14.7%) and 7 patients (6.4%) had received chemotherapy in the last month and 15 days before death, respectively.
Conclusion: Our PCDH is a suitable place for a complex population still living at home. The reported patients' demographics and PCDH's organisation lead to a hybrid outpatient intervention between outpatient clinics and hospice care services. A randomised multicentric trial is ongoing to explore the impact of PCDH on patients' trajectory and the use of resources.
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http://dx.doi.org/10.1136/spcare-2023-004206 | DOI Listing |
Palliat Support Care
January 2025
Faculdade de Medicina da Universidade de Coimbra, Universidade de Coimbra, Coimbra, Portugal.
One of the most crucial stages of palliative care is the last days and hours of life, which require special attention and knowledgeable identification of clinical signs described as signs of impending death (SID). Our case series of 11 patients receiving home palliative care describes bilateral hypoactive, stereotyped upper arm movements (scratching of the head, forehead, and nose) that were previously unknown or described, often accompanied by SID.
View Article and Find Full Text PDFRev Med Suisse
January 2025
Service de médecine palliative, Hôpitaux universitaires de Genève, 1211 Genève 14.
Patients with serious illnesses wish to maintain their autonomy and decide the course of their end of life. The role of healthcare professionals is to assess the patient's understanding of their illness, help them become aware of the progression of their condition, and adapt these conversations according to the patient's emotional state, while providing regular spaces for discussion. Some patients continue to have expectations that may seem unrealistic despite a limited prognosis.
View Article and Find Full Text PDFCureus
December 2024
Mathematics, Keio University, Yokohama, JPN.
Context: Accurate prognosis prediction for cancer patients in palliative care is critical for clinical decision-making and personalized care. Traditional statistical models have been complemented by machine learning approaches; however, their comparative effectiveness remains underexplored.
Objectives: To assess the prognostic accuracy of statistical and machine learning models in predicting 30-day survival in patients with advanced cancer using objective data, such as the result of the blood test.
Cureus
December 2024
Surgical Oncology, Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Homi Bhabha Cancer Hospital, Tata Memorial Centre, Varanasi, IND.
Thrombocytopenia is a common complication in patients with solid tumors, particularly renal cell carcinoma (RCC), arising from mechanisms such as chemotherapy, direct tumor invasion, and paraneoplastic syndromes. Managing thrombocytopenia in advanced cancer presents significant challenges, often limiting therapeutic options and impacting patient outcomes. This case report describes a 62-year-old man with metastatic RCC complicated by persistent thrombocytopenia, unresponsive to both conventional treatments and novel therapies.
View Article and Find Full Text PDFCan Pharm J (Ott)
January 2025
Saudi Innova Healthcare Company, Riyadh, Saudi Arabia.
Objective: This qualitative study aimed to describe patients' experiences of a community pharmacy (CP)-based medication therapy management program (MTM).
Methods: Qualitative, semistructured, face-to-face interviews were conducted with a purposive sample of patients with uncontrolled diabetes who received care at a CP-based MTM clinic. Interviews were conducted in the MTM clinic of Health Kingdom CP in Riyadh City, Kingdom of Saudi Arabia by a research pharmacist using an interview guide.
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