Early outpatients palliative care (EPC) in patients with metastatic cancer has been shown to impact quality of life and decrease healthcare utilization, but data describing these benefits are limited and referrals to palliative care services are often late. Our Ambulatory Unit named HOASIS offers an interdisciplinary approach to cancer management for patients.
HOASIS was created in March 2017 to receive EPC patients in order to foster autonomy and quality of life, both for patients and families. Multi-professional teams provide care in cooperation with physician.This retrospective study analyzed 152 EPC patients from march to december 2017.
In total, 152 patients were evaluable. 97% had solid tumor (mainly breast and digestive cancer, respectively 24% and 37%) and 3% had hematologic malignancies. Median age was 66 years. ECOG PS 0-1 (18%), PS 2 (52%) and PS 3-4 (28%). Most common services used were nutrition (67%), psychological counseling (39%), physical therapy (53%) and social work intervention (30%). Patients were supported to understand their prognosis with clear information about their disease and treatment (45%) and make care decisions (11%). Medical prescriptions included pain control (46%), symptomatic treatment (38%), physiotherapy (27%), psychotropics (6%) and nutritional supplements (12%). Nurses delivered the information allowing 49% to chose their trusted person and 13% both completed advance directives and trusted person. After evaluation, 29% need a second appointment, 66% had oncology consultation, 26% had phone consultation and 21% were hospitalised. Home service was supplied to 63% of them. Out of the 152 patients, 13 (9%) were seen late in our unit, less than 1 month before death, and 83 (55%) were seen more than 1 month before death. Full data about chemotherapy around end of life will be delivered during the meeting.
Professionals should integrate EPC for patients with advanced cancer. Advantages to EPC include improvement in patient’s quality of life, reduced aggressive care at the end of life, increased advanced directives. A web-based application for monitoring comfort in patients receiving EPC is currently being evaluated.
Clinical trial identification
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Has not received any funding.
All authors have declared no conflicts of interest.