TY - JOUR
T1 - Characteristics of the case mix, organisation and delivery in cancer palliative care
T2 - a challenge for good-quality research
AU - Jensen Hjermstad, Marianne
AU - Aass, Nina
AU - Aielli, Federica
AU - Bennett, M.
AU - Brunelli, C
AU - Caraceni, A
AU - Cavanna, L.
AU - Fassbender, Klaus
AU - Feio, M
AU - Haugen, Dagny Faksvåg
AU - Jakobsen, G
AU - Laird, Barry
AU - Løhre, Erik T.
AU - Martinez, M.
AU - Nabal, M.
AU - Noguera-Tejedor, A
AU - Pardon, Koen
AU - Pigni, A
AU - Piva, L
AU - Porta-Sales, Josep
AU - Rizzi, F.
AU - Rondini, E
AU - Sjøgren, Per
AU - Strasser, F.
AU - Turriziani, Adriana
AU - Kaasa, S.
AU - European Palliative Care Cancer Symptom study (EPCCS)
N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
PY - 2016/5/31
Y1 - 2016/5/31
N2 - OBJECTIVES: Palliative care (PC) services and patients differ across countries. Data on PC delivery paired with medical and self-reported data are seldom reported. Aims were to describe (1) PC organisation and services in participating centres and (2) characteristics of patients in PC programmes.METHODS: This was an international prospective multicentre study with a single web-based survey on PC organisation, services and academics and patients' self-reported symptoms collected at baseline and monthly thereafter, with concurrent registrations of medical data by healthcare providers. Participants were patients ≥18 enrolled in a PC programme.RESULTS: 30 centres in 12 countries participated; 24 hospitals, 4 hospices, 1 nursing home, 1 home-care service. 22 centres (73%) had PC in-house teams and inpatient and outpatient services. 20 centres (67%) had integral chemotherapy/radiotherapy services, and most (28/30) had access to general medical or oncology inpatient units. Physicians or nurses were present 24 hours/7 days in 50% and 60% of centres, respectively. 50 centres (50%) had professorships, and 12 centres (40%) had full-time/part-time research staff. Data were available on 1698 patients: 50% females; median age 66 (range 21-97); median Karnofsky score 70 (10-100); 1409 patients (83%) had metastatic/disseminated disease; tiredness and pain in the past 24 hours were most prominent. During follow-up, 1060 patients (62%) died; 450 (44%) <3 months from inclusion and 701 (68%) within 6 months. ANOVA and χ(2) tests showed that hospice/nursing home patients were significantly older, had poorer performance status and had shorter survival compared with hospital-patients (p<.0.001).CONCLUSIONS: There is a wide variation in PC services and patients across Europe. Detailed characterisation is the first step in improving PC services and research.TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Identifier: NCT01362816.
AB - OBJECTIVES: Palliative care (PC) services and patients differ across countries. Data on PC delivery paired with medical and self-reported data are seldom reported. Aims were to describe (1) PC organisation and services in participating centres and (2) characteristics of patients in PC programmes.METHODS: This was an international prospective multicentre study with a single web-based survey on PC organisation, services and academics and patients' self-reported symptoms collected at baseline and monthly thereafter, with concurrent registrations of medical data by healthcare providers. Participants were patients ≥18 enrolled in a PC programme.RESULTS: 30 centres in 12 countries participated; 24 hospitals, 4 hospices, 1 nursing home, 1 home-care service. 22 centres (73%) had PC in-house teams and inpatient and outpatient services. 20 centres (67%) had integral chemotherapy/radiotherapy services, and most (28/30) had access to general medical or oncology inpatient units. Physicians or nurses were present 24 hours/7 days in 50% and 60% of centres, respectively. 50 centres (50%) had professorships, and 12 centres (40%) had full-time/part-time research staff. Data were available on 1698 patients: 50% females; median age 66 (range 21-97); median Karnofsky score 70 (10-100); 1409 patients (83%) had metastatic/disseminated disease; tiredness and pain in the past 24 hours were most prominent. During follow-up, 1060 patients (62%) died; 450 (44%) <3 months from inclusion and 701 (68%) within 6 months. ANOVA and χ(2) tests showed that hospice/nursing home patients were significantly older, had poorer performance status and had shorter survival compared with hospital-patients (p<.0.001).CONCLUSIONS: There is a wide variation in PC services and patients across Europe. Detailed characterisation is the first step in improving PC services and research.TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Identifier: NCT01362816.
KW - Journal Article
U2 - 10.1136/bmjspcare-2015-000997
DO - 10.1136/bmjspcare-2015-000997
M3 - Article
C2 - 27246166
JO - BMJ Supportive and Palliative Care
JF - BMJ Supportive and Palliative Care
SN - 2045-435X
ER -