1612P - Demonstrating the complexity of need and the effectiveness of integrated palliative care: An analysis of routinely collected patient centred outcome measures

Background

Patient centred outcome measures (PCOMs) are increasingly used to structure proactive symptom assessment and help centre care around the specific needs of the patient. This study aimed to review the use of PCOMs as part of the routine care of inpatients reviewed by the integrated palliative care team in a specialist cancer centre.

Methods

Anonymised electronic palliative care PCOM data were retrieved for inpatients between 7/4/2021 to 31/01/2023, including Integrated Palliative Outcome Scale (IPOS), ECOG performance status, Australian Karnofsky Performance Status (AKPS) and Phase of Illness (POI). Descriptive statistics were used to define the complexity of palliative care needs based on IPOS, PS and POI. The effectiveness of the integrated palliative care service was evaluated by examining the difference between PCOM at initial and follow up assessment.

Results

Digital PCOM records for 1115 episodes of inpatient care were included, of which 391 had follow up data. On initial assessment 63% (703) patients had ECOG PS of 3 or 4 and 77% (864) had AKPS of less than 70. The most prevalent physical symptoms were weakness (84%, 1265), pain (80.7%, 1215), and poor mobility (72.3%, 1089). The most prevalent psychosocial symptom was family or friends feeling anxious or worried (85.8%, 1292). 83% (1250) had at least one palliative care need of severe or overwhelming intensity on initial assessment. 67.5% (753) were in an unstable POI on initial assessment, requiring urgent input. On follow up 92% (328) patients were in a stable, deteriorating or dying POI with no change to the care plan required. In patients with initial moderate to overwhelming symptoms, pain improved in 74%, nausea improved in 84%, vomiting improved in 93%, and constipation improved in 68% at follow up.

Conclusions

The high prevalence of physical and psychosocial symptoms demonstrates the complexity of needs and provides evidence of the requirement for integration of specialist palliative care services in cancer centres. The improvement in symptom scores between initial and follow up assessment demonstrates the effectiveness of integrated palliative care for cancer centre inpatients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.