Factors Influencing Survival after Discharge from an Australian Palliative Care Unit to Residential Aged Care Facilities: A Retrospective Audit

Eastman, Peter; Martin, Peter

doi:10.1089/jpm.2011.0319

Cited by 7 publications

(14 citation statements)

References 23 publications

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“…In a case series of patients with terminal malignancy, fatigue improved after RBC transfusion using the FACT‐F subscale, a tool previously validated to assess symptoms of fatigue in anemic oncology patients and a component of the Functional Assessment in Cancer Therapy Anemia (FACT‐An) scale . While many of the remaining studies suggested symptomatic benefit from transfusion, the symptom assessment tools used, including the AKPS, RUG‐ADL, generalized Symptom Assessment Score, and ESAS, while valid for general assessment of symptoms, have not been validated specifically in anemia . Furthermore, absolute improvement in symptoms without supporting statistical analysis was often considered a positive response to transfusion, making both the validity and the magnitude of clinical benefit difficult to ascertain.…”

Section: Discussionmentioning

confidence: 99%

“…24 While many of the remaining studies suggested symptomatic benefit from transfusion, the symptom assessment tools used, including the AKPS, RUG-ADL, generalized Symptom Assessment Score, and ESAS, while valid for general assessment of symptoms, have not been validated specifically in anemia. [32][33][34] Furthermore, absolute improvement in symptoms without supporting statistical analysis was often considered a positive response to transfusion, making both the validity and the magnitude of clinical benefit difficult to ascertain. The absence of comparison groups that did not receive RBC transfusion and the failure to report any adjunctive therapies provided with transfusion in most studies we reviewed further limit our interpretation of their results.…”

Section: Discussionmentioning

confidence: 99%

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Red blood cell transfusion in adult palliative care: a systematic review

et al. 2017

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BACKGROUND The risks and benefits of red blood cell (RBC) transfusion in palliative care patients remain poorly understood. We reviewed the literature to summarize available information on RBC transfusion in this population. STUDY DESIGN AND METHODS We searched electronic databases (MEDLINE, Embase, PsycINFO, CINAHL) from inception through September 2016 to identify studies reporting data on palliative patients receiving RBC transfusion. Original studies that assessed RBC transfusion as an intervention and reported at least one clinical outcome were included. Study characteristics, results on transfusion‐related outcomes, and authors' conclusions on the value of transfusion in palliative patients were abstracted and reported. RESULTS We identified 1839 studies, of which 137 were selected for data extraction and 13 were included (11 case series, one prospective cohort, and one retrospective cohort). Nine studies addressed symptom relief following transfusion using subjective symptom scales, of which eight (89%) indicated some degree of short‐term benefit and one study (11%) showed no benefit. Posttransfusion survival was reported in four studies—one demonstrated prolonged survival in patients receiving RBC transfusion; three had no comparison group. Other outcomes reported included hemoglobin values posttransfusion in four studies and adverse events following transfusion in three studies. CONCLUSIONS In palliative care, RBC transfusion may provide symptom relief and improve subjective well‐being, though the duration and magnitude of this effect, and transfusion‐associated risks specific to this population remain unclear. Currently, no high quality evidence exists to support or guide the use of RBC transfusion in this population. Moreover, the clinical heterogeneity within the palliative population limits the interpretation of most studies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Red blood cell transfusion in adult palliative care: a systematic review

et al. 2017

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“… Allocation (control or intervention) Demographics (including ethnicity) Drivers for readmission based on outcomes of a semi-structured interview at admission Smoking and alcohol consumption Co-morbidities (clinician diagnosed coronary heart disease, heart failure, rheumatic heart disease, diabetes mellitus, COPD/bronchiectasis, sleep related disorders (including obstructive sleep apnoea), and musculoskeletal disorders (type and areas/joints affected). Assessment of premorbid function status using the Resource Utilization Groups–Activities of Daily Living (RUG-ADL) [ 31 , 32 ] and Australian Modified Karnofsky Performance Scale (AKPS) [ 33 ]. Anthropometry and objective physical activity assessment including: Weight, height and BMI Sit-Rise Test (SRT) and six minute walk test (6MWT) and as a potential method for predicting patient survival and an objective, standardised and reproducible measure of exercise tolerance respectively [ 34 , 35 ].…”

Section: Methodsmentioning

confidence: 99%

“…Assessment of premorbid function status using the Resource Utilization Groups–Activities of Daily Living (RUG-ADL) [ 31 , 32 ] and Australian Modified Karnofsky Performance Scale (AKPS) [ 33 ].…”

Section: Methodsmentioning

confidence: 99%

The Alice Springs Hospital Readmission Prevention Project (ASHRAPP): a randomised control trial

Diplock

Ward

Stewart

et al. 2017

BMC Health Serv Res

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BackgroundHospitals are frequently faced with high levels of emergency department presentations and demand for inpatient care. An important contributing factor is the subset of patients with complex chronic diseases who have frequent and preventable exacerbations of their chronic diseases. Evidence suggests that some of these hospital readmissions can be prevented with appropriate transitional care. Whilst there is a growing body of evidence for transitional care processes in urban, non-indigenous settings, there is a paucity of information regarding rural and remote settings and, specifically, the indigenous context.MethodsThis randomised control trial compares a tailored, multidimensional transitional care package to usual care. The objective is to evaluate the efficacy of the transitional care package for Indigenous and non-Indigenous Australian patients with chronic diseases at risk of recurrent readmission with the aim of reducing readmission rates and improving transition to primary care in a remote setting. Patients will be recruited from medical and surgical admissions to Alice Springs Hospital and will be followed for 12 months. The primary outcome measure will be number of admissions to hospital with secondary outcomes including number of emergency department presentations, number of ICU admissions, days alive and out of hospital, time to primary care review post discharge and cost-effectiveness.DiscussionSuccessful transition from hospital to home is important for patients with complex chronic diseases. Evidence suggests that a coordinated transitional care plan can result in a reduction in length of hospital stay and readmission rates for adults with complex medical needs. This will be the first study to evaluate a tailored multidimensional transitional care intervention to prevent readmission in Indigenous and non-Indigenous Australian residents of remote Australia who are frequently admitted to hospital. If demonstrated to be effective it will have implications for the care and management of Indigenous Australians throughout regional and remote Australia and in other remote, culturally and linguistically diverse populations and settings.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12615000808549- Retrospectively registered on 4/8/15.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2077-7) contains supplementary material, which is available to authorized users.

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“…cancer, kidney disease, chronic obstructive pulmonary disease or disease of the arteries), age at admission, male gender, hospital care type (palliative rather than acute) and length of hospital episode before discharge [5]. Victorian data also suggest that for residents admitted from a specialist palliative care unit the median survival time post-transfer is 42.5 days [6].…”

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confidence: 99%

Guest commentary: Residential aged care: The de facto hospice for New Zealand's older people

Parker

Clifton

2014

Australas J Ageing

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Factors Influencing Survival after Discharge from an Australian Palliative Care Unit to Residential Aged Care Facilities: A Retrospective Audit

Abstract: This study is one of the largest investigating this cohort and suggests a number of factors that may predict survival for patients after discharge from a PCU to an RACF.

Cited by 7 publications

References 23 publications

Red blood cell transfusion in adult palliative care: a systematic review

Red blood cell transfusion in adult palliative care: a systematic review

The Alice Springs Hospital Readmission Prevention Project (ASHRAPP): a randomised control trial

Guest commentary: Residential aged care: The de facto hospice for New Zealand's older people

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