Integration and activity of hospital-based palliative care consultation teams: the INSIGHT multicentric cohort study
2017
Abstract Background Hospital-based Palliative Care Consultation Teams (PCCTs) have a consulting role to specialist services at their request.
Referralof patients is often late. Early palliative care in oncology has shown its effectiveness in improving quality of life, thereby questioning the “on request” model of PCCTs. Whether this evidence changed practice is unknown. This multicentre prospective cohort study aims to describe the activity and integration of PCCTs at the patient level. Methods For consecutive patients newly referred to participating PCCTs, the team collected the following data: circumstances of first
referral, problems identified, number of interventions, patient’s survival after first evaluation and place of death. Results Seventeen PCCTs based in university hospitals in Paris area, recruited 744 newly referred adult patients, aged 72 ± 15 years, 52% males, and 504(68%) with cancer as primary diagnosis. After 6 months, 548(74%) had died. At first evaluation, 12% patients were outpatients, 88% were inpatients. Symptoms represented the main reasons for
referraland problems identified; 79% of patients had altered performance status; 24% encountered the PCCT only once. Median survival (1st-3rd quartile) after first evaluation by the PCCT was 22 (5–82) days for overall patients, and respectively 31 (8–107) days and 9 (3–34) days for cancer versus noncancer patients (p Conclusion The study provides original data showing a still late
referralto the PCCTs in France. Cancer patients represent their predominant activity. The integrated palliative care model seems to emerge besides the “on request” model which originally characterised their missions.
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