Fully Integrated Oncology and Palliative Care Services at a Local Hospital in Mid-Norway: Development and Operation of an Innovative Care Delivery Model.

Autor: Brenne AT; European Palliative Care Research Centre (PRC), Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway. anne.tove.brenne@ntnu.no.; Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. anne.tove.brenne@ntnu.no., Knudsen AK; European Palliative Care Research Centre (PRC), Oslo University Hospital and University of Oslo, Oslo, Norway.; Department of Oncology, Oslo University Hospital, Oslo, Norway., Raj SX; European Palliative Care Research Centre (PRC), Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.; Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway., Skjelvan L; European Palliative Care Research Centre (PRC), Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.; Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway., Lund JÅ; European Palliative Care Research Centre (PRC), Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.; Department of Oncology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway., Thronæs M; European Palliative Care Research Centre (PRC), Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.; Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway., Løhre ET; European Palliative Care Research Centre (PRC), Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.; Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway., Hågensen LÅ; Coordination Unit Orkdal Region, Orkdal, Norway., Brunelli C; Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Instituto Nazionale dei Tumori, Milan, Italy., Kaasa S; European Palliative Care Research Centre (PRC), Oslo University Hospital and University of Oslo, Oslo, Norway.; Department of Oncology, Oslo University Hospital, Oslo, Norway.; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Jazyk: angličtina
Zdroj: Pain and therapy [Pain Ther] 2020 Jun; Vol. 9 (1), pp. 297-318. Date of Electronic Publication: 2020 Apr 09.
DOI: 10.1007/s40122-020-00163-7
Abstrakt: Introduction: Early access to cancer palliative care is recommended. Descriptions of structures and processes of outpatient palliative care clinics operated within smaller hospitals are scarce. This paper presents the development and operation of a fully integrated cancer and palliative care outpatient clinic at a local hospital in a rural region of Mid-Norway offering palliative care concurrent with cancer treatment. A standardized care pathway was applied.
Methods: Palliative care is in Norway part of the public healthcare system. Official recommendations recent years point out action points to improve delivery of palliative care. An integrated cancer and palliative care outpatient clinic at a local hospital and an innovative care delivery model was developed and operated in this setting. Patients were recruited for a descriptive study of the patient population. Clinical data were collected by clinical staff and 13 symptom intensities were reported by the patients.
Results: Cancer and palliative care were provided by one team of healthcare professionals trained in both fields. There was a close collaboration with the other departments at the hospital, with its affiliated tertiary hospital, and with community health and care services to provide timely referral, enhanced continuity, and improved coordination of care. Eighty-eight patients were included. Mean age was 65.6 years, the most common cancer diagnoses were digestive organs (22.7%), male genital organs (20.5%) or breast (25.0%), 75.0% had metastatic or locally advanced cancer, 59.1% were treated with non-curative intention and 93.1% had Karnofsky Performance Status ≥ 80%. Median scores of individual symptoms ranged from 0 to 3 (numerical rating scale, 0-10) and 61.0% reported at least one clinically significant symptom rating (≥ 4).
Conclusion: This delivery model of integrated outpatient cancer and palliative care is particularly relevant in rural regions allowing cancer patients access to palliative care earlier in the disease trajectory and closer to home.
Databáze: MEDLINE
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