Abstract 1459P
Background
Palliative care for advanced cancer patients improves suffering symptoms, and quality of life (QoL). However, routine implementation of palliative care by specialty palliative care consultation is still an unmet need among advanced cancer inpatients. Our study aim was to evaluate the effectiveness of a team-based approach on QoL and readmission rate when compared to routine practice by medical oncologists.
Methods
This study was a prospective, quasi-experimental design. Advanced cancer inpatients were non-randomly assigned to receive palliative care service by a team-based approach (palliative care specialists and medical oncologists) or medical oncologists only. The primary endpoint was QoL. The secondary endpoint was readmission rate at 7, and 30 days of hospital discharge. QoL were assessed by Thai-Hospital Anxiety and Depression Scale (Thai-HADS) and Thai-Functional Assessment of Cancer Therapy- General scale (Thai-FACT-G) at 1st, and 7th day of admission.
Results
One hundred twenty-two inpatients were enrolled. Patients who were assessed by a team-based approach had improvement of either anxiety or depression at day 7 of hospital discharge significantly, which anxiety scores were 6.62 ± 4.16 at baseline vs 4.9 ± 3.13 at day 7 (p-value=0.003), and depression scores were 7.05 ± 4.56 at baseline vs 4.87 ± 3.16 at day 7 (p-value<0.001). Only depression scores were significantly improved at day 7 of admission in patients who were assessed by medical oncologists (p-value=0.006). For the QoL aspect, inpatients who were assessed by a team-based approach had significantly improved in change scores of subjective well-being (SWB) when compare to the other group (Δ SWB: -1 vs 0 , p-value=0.043). Furthermore, inpatients who were assessed by a team-based approach had significantly decreased readmission rates at 7 days of hospital discharge (p-value=0.013).
Conclusions
Interdisciplinary collaboration is a key to success for establishing goals of care supporting the best possible QoL and relieving suffering symptoms for advanced cancer inpatients. Furthermore, readmission rates at 7 days of hospital discharge aresignificantly reduced by a team-based approach.
Clinical trial identification
Thai Clinical Trials Registry (TCTR) 20200312001.
Editorial acknowledgement
Legal entity responsible for the study
Division of Medical Oncology, Department of Medicine, Phramongkutklao Hospital.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.