Trend Analysis of Quality Indicators in Palliative Home Care Among Terminally Ill Cancer and Non-cancer Patients in Taiwan: a 6-year Observational Study

Overview

Journal Support Care Cancer

Specialties Critical Care
Oncology

Date 2024 Jan 3

PMID 38170324

Authors

Hao-Hsun Chung

Chun-Li Wang

Jia-Jyun Wu

Szu-Pei Chien

Lung-Chun Lee

Ya-Huei Juang

Wei-Min Chu

Affiliations

Soon will be listed here.

Abstract

Purpose: Palliative home care services (PHCS) have been emerging for years. However, limited data exist regarding quality indicators for pain control, unplanned hospital readmissions, and household deaths among terminal cancer and non-cancer patients receiving PHCS.

Methods: We conducted a retrospective collection and recording of data from 1242 terminally ill cancer and non-cancer patients receiving PHCS. The data were obtained from the Hospice-Palliative Clinical Database (HPCD) of Taichung Veterans General Hospital (TCVGH) for the period from 2016 to 2021. T test and chi-square test were applied for characteristics and the quality indicators among cancer and non-cancer groups. Chi-square test was used for trend analysis of the number of patients receiving PHCS and the quality indicators among cancer and non-cancer groups throughout the study period.

Results: A total of 1242 terminally ill cancer and non-cancer patients who had received PHCS were documented by TCVGH from the years 2016 to 2021, including 221 non-cancer patients and 1021 cancer patients having an average age of 70. The number of terminally ill cancer and non-cancer patients receiving PHCS has increased annually since 2016. Another finding was that age was a statistically significant factor impacting quality indicators. On the other hand, compared to non-cancer patients, cancer patients had a higher likelihood of receiving treatment with analgesics when needed. Their odds of needing analgesics more than three times within 4 days after PHCS enrollment were significantly elevated [OR 4.188, 95% CI (1.002, 17.51)].

Conclusion: The results of this 6-year observational study indicate a substantial increase in the number of terminal cancer and non-cancer patients receiving PHCS over the past decade. Furthermore, aging plays an important role in life quality of terminal cancer and non-cancer patients.

Citing Articles

Analyzing innovative policies and practices for palliative care in Portugal: a qualitative study.

Silva M, Telles A, Baixinho C, Sa E, Costa A, Henriques M BMC Palliat Care. 2024; 23(1):225.

PMID: 39256708 PMC: 11389312. DOI: 10.1186/s12904-024-01556-7.

References

Fitzmaurice C, Allen C, Barber R, Barregard L, Bhutta Z, Brenner H . Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol. 2016; 3(4):524-548. PMC: 6103527. DOI: 10.1001/jamaoncol.2016.5688. View

Xie Y, Bowe B, Mokdad A, Xian H, Yan Y, Li T . Analysis of the Global Burden of Disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016. Kidney Int. 2018; 94(3):567-581. DOI: 10.1016/j.kint.2018.04.011. View

Tsao C, Aday A, Almarzooq Z, Alonso A, Beaton A, Bittencourt M . Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation. 2022; 145(8):e153-e639. DOI: 10.1161/CIR.0000000000001052. View

Cao Q, Tan C, Xu W, Hu H, Cao X, Dong Q . The Prevalence of Dementia: A Systematic Review and Meta-Analysis. J Alzheimers Dis. 2019; 73(3):1157-1166. DOI: 10.3233/JAD-191092. View

Jager K, Fraser S . The ascending rank of chronic kidney disease in the global burden of disease study. Nephrol Dial Transplant. 2017; 32(suppl_2):ii121-ii128. DOI: 10.1093/ndt/gfw330. View

Savarese G, Becher P, Lund L, Seferovic P, Rosano G, Coats A . Global burden of heart failure: a comprehensive and updated review of epidemiology. Cardiovasc Res. 2022; 118(17):3272-3287. DOI: 10.1093/cvr/cvac013. View

Adeloye D, Song P, Zhu Y, Campbell H, Sheikh A, Rudan I . Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: a systematic review and modelling analysis. Lancet Respir Med. 2022; 10(5):447-458. PMC: 9050565. DOI: 10.1016/S2213-2600(21)00511-7. View

Stjernsward J, Foley K, Ferris F . The public health strategy for palliative care. J Pain Symptom Manage. 2007; 33(5):486-93. DOI: 10.1016/j.jpainsymman.2007.02.016. View

De Lima L . Palliative care and pain treatment in the global health agenda. Pain. 2015; 156 Suppl 1:S115-S118. DOI: 10.1097/01.j.pain.0000460349.23083.0b. View

10.

Hui D, Hannon B, Zimmermann C, Bruera E . Improving patient and caregiver outcomes in oncology: Team-based, timely, and targeted palliative care. CA Cancer J Clin. 2018; 68(5):356-376. PMC: 6179926. DOI: 10.3322/caac.21490. View

11.

Ferrell B, Temel J, Temin S, Alesi E, Balboni T, Basch E . Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol. 2016; 35(1):96-112. DOI: 10.1200/JCO.2016.70.1474. View

12.

Gaertner J, Siemens W, Meerpohl J, Antes G, Meffert C, Xander C . Effect of specialist palliative care services on quality of life in adults with advanced incurable illness in hospital, hospice, or community settings: systematic review and meta-analysis. BMJ. 2017; 357:j2925. PMC: 5496011. DOI: 10.1136/bmj.j2925. View

13.

Phongtankuel V, Meador L, Adelman R, Roberts J, Henderson Jr C, Mehta S . Multicomponent Palliative Care Interventions in Advanced Chronic Diseases: A Systematic Review. Am J Hosp Palliat Care. 2017; 35(1):173-183. PMC: 5879777. DOI: 10.1177/1049909116674669. View

14.

Zeng Y, Wang C, Ward K, Hume A . Complementary and Alternative Medicine in Hospice and Palliative Care: A Systematic Review. J Pain Symptom Manage. 2018; 56(5):781-794.e4. DOI: 10.1016/j.jpainsymman.2018.07.016. View

15.

Gade G, Venohr I, Conner D, McGrady K, Beane J, Richardson R . Impact of an inpatient palliative care team: a randomized control trial. J Palliat Med. 2008; 11(2):180-90. DOI: 10.1089/jpm.2007.0055. View

16.

Piamjariyakul U, Petitte T, Smothers A, Wen S, Morrissey E, Young S . Study protocol of coaching end-of-life palliative care for advanced heart failure patients and their family caregivers in rural appalachia: a randomized controlled trial. BMC Palliat Care. 2019; 18(1):119. PMC: 6936135. DOI: 10.1186/s12904-019-0500-z. View

17.

Lin L, Huang L, Chang Y, Wang C, Lee L, Hu C . Trend analysis of palliative care consultation service for terminally ill non-cancer patients in Taiwan: a 9-year observational study. BMC Palliat Care. 2021; 20(1):181. PMC: 8614035. DOI: 10.1186/s12904-021-00879-z. View

18.

Kirchhoff K, Hammes B, Kehl K, Briggs L, Brown R . Effect of a disease-specific advance care planning intervention on end-of-life care. J Am Geriatr Soc. 2012; 60(5):946-50. PMC: 3354033. DOI: 10.1111/j.1532-5415.2012.03917.x. View

19.

Gomes B, Calanzani N, Curiale V, McCrone P, Higginson I . Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers. Cochrane Database Syst Rev. 2013; (6):CD007760. PMC: 4473359. DOI: 10.1002/14651858.CD007760.pub2. View

20.

DiMartino L, Weiner B, Mayer D, Jackson G, Biddle A . Do palliative care interventions reduce emergency department visits among patients with cancer at the end of life? A systematic review. J Palliat Med. 2014; 17(12):1384-99. DOI: 10.1089/jpm.2014.0092. View