The Provision of a Palliative Care Service in a Teaching Hospital and Subsequent Evaluation of That Service

Abstract

A survey at a large tertiary referral hospital showed that patients with cancer and HIV disease had poorly controlled symptoms. A palliative care service was introduced, employing a doctor and part-time pharmacist. The doctor was available to see and advise about terminally ill patients. With the pharmacists, an educational programme of meetings, teaching sessions and information leaflets was developed. One year after the introduction of the service a repeat survey all patients with cancer or HIV disease was carried out. Problems on admission were similar in both surveys, but fewer patients' symptom scores deteriorated during their hospital stay. There was a significantly increased use of appropriate opioid analgesics and NSAIDs. Staff were satisfied with the service.

Does palliative care improve outcomes for patients with HIV/AIDS? A systematic review of the evidence

“…48 The identification of evidence is also hampered by studies combining diagnosis groups. For example, one study 49 reported palliative care consultations in an acute care hospital where only 8.3% of patients had HIV disease, a second study of the benefits of symptom control by a hospital based palliative care consultant and pharmacist also had only 8% of patients with HIV, 50 and a third study of parenteral antibiotics in an inpatient palliative care unit reported 15% of patients having an underlying HIV diagnosis. 51 The potential for a selection bias in HIV palliative care evaluation was demonstrated in a study that found patients reported lower levels of pain, better insight, less anxiety, and fewer spiritual problems than in providers' assessments.…”

Implementation of a palliative care team in an Austrian university hospital

“…Most of the patients visited (91.4%) suffered from malignant diseases. Data before 2000 showed that a quarter of the patients, who were visited, suffered from AIDS [21]. Introduction of antiviral therapy regimes resulted in less necessity for palliative care in developed countries.…”

Requests from professional care providers for consultation with palliative care consultation teams

“…Similarly, studies on requests for professional consultation in the field of palliative care are also scarce. In much of the literature, consultation only appears as a side issue among support teams whose primary task was the direct provision of care to the patient and family [3,5,8,12,[17][18][19]. A few studies addressed purely advisory services [1,31] or concentrated on referrals to consultation services [13,29].…”