The Comprehensive Care Team

Rabow, Michael W.; Dibble, Suzanne L.; Pantilat, Steven Z.; McPhee, Stephen J.

doi:10.1001/archinte.164.1.83

Cited by 418 publications

(129 citation statements)

References 47 publications

Supporting

Mentioning

127

Contrasting

Order By: Relevance

“…8 The Project ENABLE II randomized trial found that a nurse-led concurrent palliative care intervention improved the QOL and mood of patients with advanced gastrointestinal, lung, genitourinary, or breast cancer. 9 Several other palliative care trials published over the last 10 years observed better patient satisfaction, 10,11 improved QOL in family caregivers, 12 improved symptom relief, 13 and lower health care costs. 10,11 The American Society of Clinical Oncology (ASCO) issued a Provisional Clinical Opinion with recommendations that all cancer patients with metastatic disease and/or high symptom burden be given concurrent palliative and oncology care.…”

Section: Introductionmentioning

confidence: 95%

Interdisciplinary Palliative Care for Patients With Lung Cancer

Ferrell

Sun

Hurria

et al. 2015

Journal of Pain and Symptom Management

176

115

View full text Add to dashboard Cite

Context Palliative care, including symptom management and attention to quality of life (QOL) concerns, should be addressed throughout the trajectory of a serious illness such as lung cancer. Objectives This study tested the effectiveness of an interdisciplinary palliative care intervention for patients with stage I–IV non-small cell lung cancer (NSCLC). Methods Patients undergoing treatments for NSCLC were enrolled in a prospective, quasi-experimental study whereby the usual care group was accrued first followed by the intervention group. Patients in the intervention group were presented at interdisciplinary care meetings, and appropriate supportive care referrals were made. They also received four educational sessions. In both groups, QOL, symptoms, and psychological distress were assessed at baseline and 12 weeks using surveys which included the Functional Assessment of Cancer Therapy-Lung and the lung cancer subscale, the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, and the Distress Thermometer. Results A total of 491 patients were included in the primary analysis. Patients who received the intervention had significantly better scores for QOL (109.1 vs. 101.4; P<0.001), symptoms (25.8 vs. 23.9; P<0.001) spiritual well-being (38.1 vs. 36.2; P=0.001), and lower psychological distress (2.2 vs. 3.3; P<0.001) at 12 weeks, after controlling for baseline scores, compared to patients in the usual care group. Patients in the intervention group also had significantly higher numbers of completed advance care directives (44% vs. 9%; P<0.001), and overall supportive care referrals (61% vs. 28%; P<0.001). The benefits were seen primarily in the earlier stage patients versus those with stage IV disease. Conclusion Interdisciplinary palliative care in the ambulatory care setting resulted in significant improvements in QOL, symptoms, and distress for NSCLC patients.

show abstract

Section: Introductionmentioning

confidence: 95%

Interdisciplinary Palliative Care for Patients With Lung Cancer

Ferrell

Sun

Hurria

et al. 2015

Journal of Pain and Symptom Management

176

115

View full text Add to dashboard Cite

show abstract

“…Integrating palliative care early in the course of treatment for patients with terminal cancer has gained attention in recent years as a promising strategy for improving patients’ quality of life (QOL)[1,2] and extending their survival. [3] In addition, early palliative care has been linked with measures of less aggressive end-of-life care.…”

Section: Introductionmentioning

confidence: 99%

Early supportive medication use and end-of-life care among Medicare beneficiaries with advanced breast cancer

Check

Rosenstein

Dusetzina

2016

Support Care Cancer

View full text Add to dashboard Cite

Purpose A randomized controlled trial of cancer patients has linked early supportive care with improved hospice use and less aggressive end-of-life care. In practice, the early use of supportive interventions and potential impact on end-of-life care are poorly understood. We sought to describe early use of medications to treat common breast cancer symptoms (pain, insomnia, anxiety, and depression) and to assess the relationship between early use of these treatments and end-of-life care. Methods Secondary analysis of 2006–2012 SEER-Medicare data. Women included had stage IV breast cancer and died within the observation period. We used modified Poisson regression to assess the relationship between supportive medication use in the 90 days post-diagnosis and several end-of-life care measures (hospice use, in-hospital death, chemotherapy receipt within 14 days of death, ICU admission or >1 hospitalization or emergency department/ED visit 30 days before death). Results Among the 947 women included, 68% of women used at least one supportive medication in the 90 days following their diagnosis: 60.3% used opioid pain medications, and 28.3% received non-opioid psychotropic medications. Early use of any supportive medications was not associated with end-of-life care. Similarly, we found no differences in end-of-life care between opioid pain medication users and non-users. However, we found that non-opioid psychotropic medication users were less likely to receive chemotherapy in the last 14 days of life (aRR: 0.33, 95% CI: 0.12–0.88). Conclusions Non-opioid psychotropic use was associated with some aspects of end-of-life care. Future research should consider alternative measures of palliative and supportive care use using administrative data sources.

show abstract

“…While traditional approaches to symptomatic distress often focus primarily on the management of physical symptoms, this study’s findings add to a growing body of literature suggesting that different forms of distress are often interconnected, co-occurring, and relevant to the overall health outcomes of older adults. 5,7,8, 9,20 …”

Section: Discussionmentioning

confidence: 99%

“…For example, physical symptoms are independently associated with worsening quality of life, future functional impairment, patient dissatisfaction, and increased healthcare costs via greater primary care and urgent care visits. 7,8 Psychological and social symptoms also contribute to worse physical distress and poorer health outcomes. 9,10 And a growing body of evidence suggests that existential suffering, which adversely affects quality of life and overall well-being, may also contribute to worse physical health among the seriously ill, though the literature exploring the link between existential distress and physical health outcomes is still in its early stages.…”

Section: Introductionmentioning

confidence: 99%

Detained and Distressed: Persistent Distressing Symptoms in a Population of Older Jail Inmates

Bolano

Ahalt

Ritchie

et al. 2016

J American Geriatrics Society

View full text Add to dashboard Cite

Among older adults, distressing symptoms are associated with decreased function, acute care use and mortality. The number of older jail inmates is increasing rapidly, prompting calls to develop systems of care to meet their healthcare needs. Yet little is known about multidimensional symptom burden in this population. This cross-sectional study describes the prevalence and factors associated with distressing symptoms and the overlap between different forms of symptom distress in 125 older jail inmates in an urban county jail. Physical distress was assessed using the Memorial Symptom Assessment Scale. Several other forms of symptom distress were also examined, including: psychological (GAD-2 and PHQ-2), existential (Patient Dignity Inventory), and social (Three Item Loneliness Scale). Participant sociodemographics, multimorbidity, serious mental illness (SMI), functional impairment and behavioral health risk factors were collected through self-report and chart review. Chi-squared tests were used to identify factors associated with physical distress. Overlap between forms of distress was evaluated using set theory analysis. Overall, many participants (74%) reported distressing symptoms including having one or more physical (44%), psychological (37%), existential (54%), or social (45%) symptom. Physical distress was associated with poor health (multimorbidity, functional impairment, SMI) and low income. Of the 93 participants with any symptom, 49% reported 3 or more forms of distress. These findings suggest that an optimal model of care for this population would include a geriatrics-palliative care approach that integrates the management of all forms of symptom distress into a comprehensive treatment paradigm stretching from jail to the community.

show abstract

The Comprehensive Care Team

Abstract: Consultation by a palliative medicine team led to improved patient outcomes in dyspnea, anxiety, and spiritual well-being, but failed to improve pain or depression. Palliative care for seriously ill outpatients can be effective, but barriers to implementation must be explored.

Cited by 418 publications

References 47 publications

Interdisciplinary Palliative Care for Patients With Lung Cancer

Interdisciplinary Palliative Care for Patients With Lung Cancer

Early supportive medication use and end-of-life care among Medicare beneficiaries with advanced breast cancer

Detained and Distressed: Persistent Distressing Symptoms in a Population of Older Jail Inmates

Contact Info

Product

Resources

About