Palliative care for patients undergoing stem cell transplant: intervention components and supportive care measures
Autor: | Matthew J. Reynolds, P. Connor Johnson, Alisha M. Yi, Areej El-Jawahri, Ashley M. Nelson, Alison R. Kavanaugh, Jennifer S. Temel, Nora Horick, Carlisle E.W. Topping, Annemarie D. Jagielo, Alyssa L. Fenech, Joseph A. Greer, Vicki A. Jackson |
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Rok vydání: | 2021 |
Předmět: |
Transplantation
medicine.medical_specialty Coping (psychology) Palliative care business.industry Medical record Palliative Care Hematopoietic Stem Cell Transplantation MEDLINE Hematology Article law.invention Mood Randomized controlled trial law Intervention (counseling) Adaptation Psychological Quality of Life Physical therapy medicine Humans business Treatment Arm Stem Cell Transplantation |
Zdroj: | Bone Marrow Transplant |
ISSN: | 1476-5365 0268-3369 |
Popis: | An inpatient palliative care intervention during HCT led to improvement in patient QOL and mood. We sought to describe components of the intervention, investigate differences in supportive care practices by treatment arm, and explore whether these differences mediated the impact of the intervention on patient QOL and mood. We conducted a secondary analysis of a randomized trial investigating inpatient palliative care integrated with transplant care versus standard transplant care for HCT recipients. Palliative care clinicians completed weekly surveys to describe topics addressed during visits. We extracted use of supportive care medications from the medical record. Participants completed QOL and mood assessments at baseline and two weeks post-HCT. Causal mediation assessed whether differences in supportive care practices mediated the impact of the intervention on patient-reported outcomes. A total of 160 HCT recipients participated. Palliative care visits most frequently focused on managing symptoms and coping with HCT. Patients randomized to the intervention were more likely to use Patient-Controlled Analgesia (PCA) (32.1% vs. 15.2%, p = 0.02) and atypical antipsychotics (35.8% vs. 17.7%, p = 0.01). Neither PCA nor atypical antipsychotics mediated the effect of the intervention on patient-reported outcomes. Future work to explore mechanisms by which the palliative care intervention improves QOL and mood is needed. |
Databáze: | OpenAIRE |
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