Skip to main content

Advertisement

SpringerLink
Log in

Relationship between palliative care consultation service and end-of-life outcomes

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Palliative care consultation service (PCCS) is currently utilized to provide care to terminal patients in Taiwan. However, there is little research on the relationship between PCCS and end-of-life outcomes. This study aimed to elucidate the association between PCCS and end-of-life outcomes in terminal cancer patients.

Methods

Retrospective chart reviews of terminal cancer patients who consulted the PCCS of a medical center in Taiwan from January 2007 to December 2012 were performed. Data on 1369 patients were recorded, which included details of outcomes such as discharge from hospital, transfer to hospice ward, and death after PCCS termination. Other variables such as demographics, disease-related information, symptoms, and psychosocial needs were also evaluated. Logistic regression models were employed to estimate the adjusted odds ratios and related 95 % confidence intervals.

Results

The Eastern Cooperative Oncology Group performance status, timing of do-not-resuscitate (DNR) signature, constipation, and spiritual problems experienced by the patients were important predictors for terminal cancer patients who were discharged from the hospital or had expired at the time of PCCS termination. Age, gender, primary cancer diagnosis, timing of DNR signature, constipation, and other physical symptoms were the key predictors for patients who were transferred to the hospice ward or had expired.

Conclusions

This study confirms the outcomes of PCCS and highlights the important predictors for patients at PCCS termination. These factors can be targeted to improve and enhance the quality of PCCS rendered in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kang SC, Lin MH, Hwang IH, Lin MH, Chang HT, Hwang SJ (2012) Impact of hospice care on end-of-life hospitalization of elderly patients with lung cancer in Taiwan. J Chin Med Assoc 75(5):221–226. doi:10.1016/j.jcma.2012.04.005

    Article  PubMed  Google Scholar 

  2. World Health Organization (2002) National cancer control programmes: policies and managerial guidelines, 2nd edn. World Health Organization, Geneva

    Google Scholar 

  3. Engeser P, Hermann K, Szecsenyi J, Peters-Klimm F (2014) Symptom control and place of death in palliative cancer patients in primary care: results of the controlled PAMINO evaluation study. Schmerz 28(6):607–613. doi:10.1007/s00482-014-1464-9

    Article  CAS  PubMed  Google Scholar 

  4. Edwin AK, McGee SJ, Opare-Lokko EA, Gyakobo MK (2014) A structured approach to end-of-life decision making improves quality of care for patients with terminal illness in a teaching hospital in Ghana. Am J Hosp Palliat Care. doi: 10.1177/1049909114557350

  5. van der Eerden M, Csikos A, Busa C, Hughes S, Radbruch L, Menten J, Hasselaar J, Groot M (2014) Experiences of patients, family and professional caregivers with integrated palliative care in Europe: protocol for an international, multicenter, prospective, mixed method study. BMC Palliat Care 13(1):52. doi:10.1186/1472-684x-13-52

    Article  PubMed Central  PubMed  Google Scholar 

  6. Chang PM, Liu YY, Chao TC, Lin HL, Chen MB, Chen PM, Chiou TJ (2010) A new hospice consulting system for terminal cancer patients in transferring to post-acute care options in Taiwan. Eur J Cancer Care 19(2):267–272. doi:10.1111/j.1365-2354.2008.00983.x

    Article  Google Scholar 

  7. Chou WC, Hung YS, Kao CY, Su PJ, Hsieh CH, Chen JS, Liau CT, Lin YC, Liaw CC, Wang HM (2013) Impact of palliative care consultative service on disease awareness for patients with terminal cancer. Support Care Cancer 21(7):1973–1981. doi:10.1007/s00520-013-1733-7

    Article  PubMed  Google Scholar 

  8. Yang CH, Chiu YW, Huang CT, Haung YW, Chuang HY (2013) A comprehensive approach in hospice shared care in Taiwan: nonelderly patients have more physical, psychosocial and spiritual suffering. Kaohsiung J Med Sci 29(8):444–450. doi:10.1016/j.kjms.2012.12.005

    Article  PubMed  Google Scholar 

  9. Loke SS, Rau KM, Huang CF (2011) Impact of combined hospice care on terminal cancer patients. J Palliat Med 14(6):683–687. doi:10.1089/jpm.2010.0331

    Article  PubMed Central  PubMed  Google Scholar 

  10. Casarett D, Pickard A, Bailey FA, Ritchie C, Furman C, Rosenfeld K, Shreve S, Chen Z, Shea JA (2008) Do palliative consultations improve patient outcomes? J Am Geriatr Soc 56(4):593–599. doi:10.1111/j.1532-5415.2007.01610.x

    Article  PubMed  Google Scholar 

  11. Chand P, Gabriel T, Wallace CL, Nelson CM (2013) Inpatient palliative care consultation: describing patient satisfaction. Perm J 17(1):53–55. doi:10.7812/TPP/12-092

    Article  PubMed Central  PubMed  Google Scholar 

  12. Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655

    Article  CAS  PubMed  Google Scholar 

  13. Flannelly KJ, Emanuel LL, Handzo GF, Galek K, Silton NR, Carlson M (2012) A national study of chaplaincy services and end-of-life outcomes. BMC Palliat Care 11:10. doi:10.1186/1472-684X-11-10

    Article  PubMed Central  PubMed  Google Scholar 

  14. Kao CY, Wang HM, Tang SC, Huang KG, Jaing TH, Liu CY, Liu KH, Shen WC, Wu JH, Hung YS, Hsu HC, Chen JS, Liau CT, Lin YC, Su PJ, Hsieh CH, Chou WC (2014) Predictive factors for do-not-resuscitate designation among terminally ill cancer patients receiving care from a palliative care consultation service. J Pain Symptom Manag 47:271–282. doi:10.1016/j.jpainsymman.2013.03.020

    Article  Google Scholar 

  15. Cheng SY, Dy S, Hu WY, Chen CY, Chiu TY (2012) Factors affecting the improvement of quality of dying of terminally ill patients with cancer through palliative care: a ten-year experience. J Palliat Med 15(8):854–862. doi:10.1089/jpm.2012.0033

    Article  PubMed  Google Scholar 

  16. Tsai JS, Wu CH, Chiu TY, Hu WY, Chen CY (2006) Symptom patterns of advanced cancer patients in a palliative care unit. Palliat Med 20:617–622. doi:10.1177/0269216306071065

    Article  PubMed  Google Scholar 

  17. Lal M, Raheja S, Kale S, Das N, Gogia AR, Bhowmik KT (2012) An experience with 156 patients attending a newly organized pain and palliative care clinic in a tertiary hospital. Indian J Cancer 49:293–297

    Article  CAS  PubMed  Google Scholar 

  18. Miyashita M, Arai K, Yamada Y, Owada M, Sasahara T, Kawa M, Mukaiyama T (2009) Discharge from a palliative care unit: prevalence and related factors from a retrospective study in Japan. J Palliat Med 12:142–149. doi:10.1089/jpm.2008.0216

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by the grants from the Tri-Service General Hospital, Taiwan (TSGH-C103-152).

Conflict of interest

The authors declare that this study has no conflict of interest and financial support.

Author information

Authors and Affiliations

  1. Department of Nursing, Tri-Service General Hospital, Taipei City, Taiwan

    Li-Fen Wu & Hsueh-Hsing Pan

  2. School of Public Health, National Defense Medical Center, Taipei City, Taiwan

    Chi-Ming Chu

  3. Division of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan

    Yu-Guang Chen & Ching-Liang Ho

  4. School of Nursing, National Defense Medical Center, Taipei City, Taiwan

    Hsueh-Hsing Pan

Authors
  1. Li-Fen Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chi-Ming Chu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yu-Guang Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ching-Liang Ho
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hsueh-Hsing Pan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hsueh-Hsing Pan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wu, LF., Chu, CM., Chen, YG. et al. Relationship between palliative care consultation service and end-of-life outcomes. Support Care Cancer 24, 53–60 (2016). https://doi.org/10.1007/s00520-015-2741-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-015-2741-6

Keywords

Search

Navigation