What determines referral of UK patients with haematological malignancies to palliative care services? An exploratory study using hospital records

被引:24
作者
Ansell, Pat
Howell, Debra
Garry, Anne
Kite, Suzanne
Munro, Janet
Roman, Eve
Howard, Martin
机构
[1] Univ York, Dept Hlth Sci, Epidemiol & Genet Unit, York YO10 5DD, N Yorkshire, England
[2] NHS Trust, Leeds Teaching Hosp, Leeds, W Yorkshire, England
[3] Univ York, Dept Hlth Sci, York, N Yorkshire, England
[4] York Hosp NHS Trust, York, N Yorkshire, England
关键词
comorbidity; haematological malignancy; palliative care services;
D O I
10.1177/0269216307082020
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
We investigated the frequency and characteristics of patients with haematological malignancies (HMs) who were, or were not, referred for specialist palliative care (SPC). Data were abstracted from hospital records of 108 patients who died - 27 with leukaemia, 11 with myelodysplastic syndromes, 48 with lymphoma and 22 with myeloma. Ninety-three patients (86.1 %) were >60 years of age at diagnosis, with 33 (30.6%) being >= 80 years and 31 (28.7%) having existing comorbidities. Thirty-three patients (30.6%) were referred to SPC services. There was little difference by age or HM diagnosis in referred patients. Seventeen of 67 patients (25.4%) dying on a hospital ward received SPC compared with 6/7 (85.7%) dying at home. Time between diagnosis and death influenced the referral - 24/52 patients (46.2%) dying >= 30 days after diagnosis received SPC compared with 8/42 (19.1 %) dying within 30 days. In 14 patients, HM diagnosis was confirmed after death. Identification of these 14 patients is likely to be a unique feature of our study, as patients were selected from a regional, population-based register with centralized diagnostic services, enabling the identification of all patients with HM. The interface between curative and palliative treatment in HM is more complex than the National Institute for Clinical Excellence recommendations suggest.
引用
收藏
页码:487 / 492
页数:6
相关论文
共 13 条
[1]   Which terminally ill cancer patients in the United Kingdom receive care from community specialist palliative care nurses? [J].
Addington-Hall, J ;
Altmann, D .
JOURNAL OF ADVANCED NURSING, 2000, 32 (04) :799-806
[2]  
[Anonymous], IMPR OUTC HAEM CANC
[3]  
[Anonymous], 2003, CARE DYING PATHWAY E
[4]   Australasian haematologist referral patterns to palliative care: lack of consensus on when and why [J].
Auret, K ;
Bulsara, C ;
Joske, D .
INTERNAL MEDICINE JOURNAL, 2003, 33 (12) :566-571
[5]   Palliative care as a framework for older people's long-term care [J].
Hallberg, Ingalill Rahm .
INTERNATIONAL JOURNAL OF PALLIATIVE NURSING, 2006, 12 (05) :224-229
[6]   The coverage of cancer patients by designated palliative services: a population-based study, South Australia, 1999 [J].
Hunt, RW ;
Fazekas, BS ;
Luke, CG ;
Priest, KR ;
Roder, DM .
PALLIATIVE MEDICINE, 2002, 16 (05) :403-409
[7]   Special considerations for haematology patients in relation to end-of-life care: Australian findings [J].
McGrath, P. ;
Holewa, H. .
EUROPEAN JOURNAL OF CANCER CARE, 2007, 16 (02) :164-171
[8]   End-of-life care for hematological malignancies: the "technological imperative" and palliative care [J].
McGrath, P .
JOURNAL OF PALLIATIVE CARE, 2002, 18 (01) :39-47
[9]  
McGrath Pam, 2006, Int J Nurs Pract, V12, P295, DOI 10.1111/j.1440-172X.2006.00585.x
[10]  
*NAT I CLIN EXC, 2003, IMPRO OUTC HAEM CANC