The provision of personalized, symptom oriented, patient centered care at an early stage in the patient’s trajectory of illness is the philosophy that underlies supportive care.
A questionnaire based on clinical scenarios encountered in the integrated inpatient palliative medicine unit was carried out among the registered delegates of the annual Indian association of Palliative care conference.
Interventional pain procedures (65.49 percent) and counseling regarding goals of care and provision of palliative sedation (57.75 percent) were considered the main indications for an inpatient palliative medicine unit admission. A majority (66.89 percent) agreed that the duration of inpatient stay should be defined by the stage of the illness. 48.9 percent agreed that pulse oximetry should be available for all inpatients. Acute kidney injury and dyselectrolytemia were considered valid indications for an ICU admission. 36.9 percent felt that use of non-invasive ventilation strategies, antibiotic stewardship, management of sepsis and dyselectrolytemia should be duties of a palliative medicine professional in the ICU. 48.3 percent, 65.31 percent and 50.34 percent of individuals reported that the timing of intervention, healthcare professional involved and subset of patients involved were the differences between supportive oncology and palliative medicine.Table: 1765P
Purview of early palliative medicine
|1.||Management of complex psychiatric symptoms||34.87 %|
|2.||Management of chemotherapy related complications||40.79 %|
|3.||Counselling regarding goals of care||80.92 %|
|4.||Assessment of quality of life||73.68 %|
|5.||Interventional pain management techniques||50.66 %|
There is an overlap in nature of supportive medicine services provided by a medical oncology and palliative/supportive medicine team. A practical, cost effective and resource intensive solution lies in building a workforce of health care professionals from palliative/supportive medicine who are well trained in supportive oncology. Inpatient admission is integral to sustain a cost effective model of delivery of supportive medicine services, however a consensus on the guidelines which govern the establishment and functioning of such a unit need to be developed.
Clinical trial identification
Legal entity responsible for the study
Rahul D. Arora.
Has not received any funding.
The author has declared no conflicts of interest.