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Journal of Palliative Medicine
Characteristics, Findings, and Outcomes of Palliative Care Inpatient Consultations at a Comprehensive Cancer Center
To cite this article:
Fadi Braiteh, Badi El Osta, J. Lynn Palmer, Suresh K. Reddy, Eduardo Bruera.
Journal of Palliative Medicine.
August 2007,
10(4): 948-955.
doi:10.1089/jpm.2006.0257.
Published in Volume: 10 Issue 4: September 5, 2007
Fadi Braiteh, M.D.Department of Palliative Care and Rehabilitation Medicine, The University of Texas—M.D. Anderson Cancer Center, Houston, Texas. Badi El Osta, M.D.Department of Palliative Care and Rehabilitation Medicine, The University of Texas—M.D. Anderson Cancer Center, Houston, Texas. J. Lynn Palmer, Ph.D.Department of Palliative Care and Rehabilitation Medicine, The University of Texas—M.D. Anderson Cancer Center, Houston, Texas. Suresh K. Reddy, M.D.Department of Palliative Care and Rehabilitation Medicine, The University of Texas—M.D. Anderson Cancer Center, Houston, Texas. Eduardo Bruera, M.D.Department of Palliative Care and Rehabilitation Medicine, The University of Texas—M.D. Anderson Cancer Center, Houston, Texas. Purpose: There is limited information available about the role and effect of a palliative care consultation service (mobile team, MT) in patient care. The purpose of this retrospective chart review was to determine the characteristics, findings, and outcomes of patients referred to MT in a comprehensive cancer center and to thereby gain information about its role in this setting. Patients and Methods: The study group was 61 consecutive patients assessed by one MT during 2-month period. We reviewed their charts for information about demographic and disease features, reasons for consultation, findings, interventions, and outcomes. Results: Patients were mainly referred by thoracic (n = 21; 34%), genitourinary (n = 10; 16%), and gynecology (n = 9; 15%) services. The majority of patients had metastatic disease (n = 56; 92%). Evaluation of pain was the main reason for the consultation (n = 47; 77%) followed by delirium (n = 10; 16%). The MT found a total of 449 symptoms (median 8 per patient), whereas the referring team had mentioned only 86 (1 symptom per patient) in their requests. Twenty patients (38%) screened positive for a history of alcoholism. The MT diagnosed delirium in 34 patients (56%) and frequently found features of opioid-induced side effects, such as sedation (n = 46; 75%), constipation (n = 43; 70%), and confusion (n = 34; 56%). Frequent MT interventions were: administration of neuroleptics (n = 33; 54%), opioid rotation (n = 30; 49%), and enema (n = 33; 54%). Seventeen patients (28%) showed symptoms improvement within 24 hours and 23 patients within 72 hours (38%). Twenty-five patients (41%) required transfer to the palliative care unit. Conclusions: The MT had a positive impact on these patients' care in terms of clinical findings and outcomes. Further investigations are warranted.  This paper was cited by:Symptom distress, interventions, and outcomes of intensive care unit cancer patients referred to a palliative care consult team Marvin O. Delgado-Guay, Henrique A. Parsons, Zhijun Li, Lynn J. Palmer, Eduardo Bruera Cancer. Feb 2009, Vol. 115, No. 2: 437-445 CrossRef Cognitive failure in end of life Christoph Ostgathe, Jan Gaertner, Raymond Voltz Current Opinion in Supportive and Palliative Care. Oct 2008, Vol. 2, No. 3: 187-191 CrossRef Alcoholism Screening in Patients with Advanced Cancer: Impact on Symptom Burden and Opioid Use Henrique A. Parsons, Marvin Omar Delgado-Guay, Badi El Osta, Ray Chacko, Valerie Poulter, J. Lynn Palme, Eduardo Bruera Journal of Palliative Medicine. Sep 2008, Vol. 11, No. 7: 964-968 Abstract | Full Text PDF | Reprints & PermissionsInterval between First Palliative Care Consult and Death in Patients Diagnosed with Advanced Cancer at a Comprehensive Cancer Center Badi El Osta, J. Lynn Palmer, Timotheos Paraskevopoulos, Be-Lian Pei, Lynn E. Roberts, Valerie A. Poulter, Ray Chacko, Eduardo Bruera Journal of Palliative Medicine. Jan 2008, Vol. 11, No. 1: 51-57 Abstract | Full Text PDF | Reprints & Permissions
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