| Autor: |
Chai GT; Department of Respiratory and Critical Care Medicine, 63703Tan Tock Seng Hospital, Singapore.; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.; The Palliative Care Centre for Excellence in Research and Education, Singapore., Neo HY; The Palliative Care Centre for Excellence in Research and Education, Singapore.; Department of Palliative Medicine, 568591Tan Tock Seng Hospital, Singapore., Abisheganaden J; Department of Respiratory and Critical Care Medicine, 63703Tan Tock Seng Hospital, Singapore.; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore., Hum AYM; The Palliative Care Centre for Excellence in Research and Education, Singapore.; Department of Palliative Medicine, 568591Tan Tock Seng Hospital, Singapore. |
| Jazyk: |
angličtina |
| Zdroj: |
The American journal of hospice & palliative care [Am J Hosp Palliat Care] 2022 Dec; Vol. 39 (12), pp. 1443-1451. Date of Electronic Publication: 2022 Apr 07. |
| DOI: |
10.1177/10499091221083575 |
| Abstrakt: |
Background: Interstitial lung disease (ILD) is associated with poor quality of life (QoL) and high symptom burden. Studies evaluating the benefits of palliative care examined mainly idiopathic pulmonary fibrosis (IPF) patients. We aim to examine the impact of palliative care on a broader group of fibrotic ILD patients. Methods: Single center retrospective cohort study comparing deceased ILD patients who received outpatient palliative care services (palliative-intervention group) against a usual care group. Results: Of 63 subjects, 26 (41%) were in the palliative-intervention group and 37 (59%) in the usual care group. Median time to palliative care referral was 8.6 (IQR .3-21.2) months. Dyspnea-related disability was greater in the palliative-intervention group [mMRC dyspnea score 3.5(IQR 2-4) vs 2(IQR 2-4), P = .039], with more patients requiring long term oxygen therapy (70% vs 30%, P < .001). There was no difference in the median number of hospitalizations or length of stay in the last 6 months of life. Patients in the palliative-intervention group had a higher uptake of advance care planning (ACP) (39% vs 11%, P = .014), lower frequency of intensive care unit (ICU) admissions (5% vs 19%, P = .102) and were prescribed more opioids (96% vs 27%, P < .001) and benzodiazepines (39% vs 14%, P = .022). The palliative-intervention group experienced a longer median survival of 23.9 months (95% confidence interval [CI] 14.1-33.7) compared to the usual group (11.4 months [95% CI 5.4-17.3] (log-rank test: P = .023). Male gender was a strong predictor of 1-year mortality. Conclusions: The palliative-intervention group received earlier pharmacologic intervention for symptom relief. Healthcare utilization was not increased despite greater dyspnea-related disability. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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