HIGHLIGHTS FROM THE 17th WORLD CONGRESS ONLINE OF THE EUROPEAN ASSOCIATION FOR PALLIATIVE CARE (EAPC) 2021…
Mike Lucey, Consultant in Palliative Medicine at Milford Care Centre, Limerick, Ireland, tells us more about the winning paper he co-authored that was awarded ‘Best European Paper published in 2020’ by ‘Journal of Palliative Medicine’. And there is FREE access to the full-text article until 12 December 2021
PCOC Ireland Operations team, left to right: Feargal Twomey and Martina O Reilly (Milford Care Centre), Jacinta Kelly (Sligo Hospice), Brian Creedon (Waterford Regional Hospital), Michael Lucey and Siobhain Coffey (Milford Hospice)
It is a great honour to receive the award for the best European paper published in Journal of Palliative Medicine in 2020 for our manuscript, ‘Is inpatient hospice care clinically effective? Using phase of illness to evaluate care outcomes for patients admitted to a specialist palliative care unit (SPCU) in Ireland.’ Dr Charles von Gunten, Editor-in-Chief of Journal of Palliative Medicine, presented the award at the EAPC 17th World Congress Online “Exploring New Dimensions”, on 8 October 2021.
Measuring quality in Palliative Care has traditionally been viewed as challenging, or even unachievable, due to the holistic nature of our care and the burden of illness experienced by our patients. Reflecting the effectiveness of our care to patients, families, the wider healthcare community, and society has proved difficult. However, quality assurance and improvement necessitate accurate reflection of the benefits of our interventions. A simple framework therefore is needed to document this.
Our study used bedside-documented, case mix tools developed by the Palliative Care Outcomes Collaboration (PCOC) in Australia. These tools document the patient’s phase of illness, problem severity score, psychological distress, family and carer distress, and two measures of functional status (the Australian Kanefsky’s performance score and the Resource Utilisation Guide of activities of daily living). These were measured daily and at phase change for all our patients.
Of 400 sequential patients admitted to our SPCU, 85% (n=342) had complete data recorded, reflecting the high rate of data documentation achievable. Of these patients, 43% (n=147) were in an unstable phase, 28.6% (n=98) were in a stable phase, 22% (n=76) were in a deteriorating phase and 8.7% (n=21) were in a terminal phase. Of those in an unstable phase, 60.7% (n=74) became stable within 48 hours and 70.7% (n=87) within 72 hours of admission. Unstable phase proved a driver of all symptoms and distress. Over the 14 days after admission (the median length of stay in our unit), there was a significant, progressive, and linear improvement in all symptoms and distress with a sustained increase in the proportion of or patients becoming stable phase. Functional status also showed significant improvements at day four and day fourteen. Overall, inpatient care in our unit resulted in substantial improvements in all symptoms, psychological distress, carer distress and functional status.
The implications of this study are profound. Demonstration to patients and families that admission to hospice is associated with significant and sustained improvements in all aspects of their symptoms, distress, and ability to function, steers perceptions of hospice admission away from the traditional view of hospice being only for end-of-life support. This can be reassuring for all concerned. From a service development perspective, that all these benefits were provided outside of the acute hospital system (and at a reduced cost as studies have demonstrated) can steer future efficient and effective funding initiatives. Further studies are nearing completion on our site in the areas of triage and case mix management with PCOC tools and a qualitative analysis of staff and patient perceptions of their use.
We look forward to sharing these results with you all soon.
Editor’s note: This post is among the Top Twenty most-viewed posts for 2021.
Download a FREE copy of the full-text article from ‘Journal of Palliative Medicine’ until 12 December 2021…
This post relates to the longer article, ‘Is inpatient hospice care clinically effective? Using phase of illness to evaluate care outcomes for patients admitted to a specialist palliative care unit in Ireland’, by Michael Lucey, Martina O’Reilly, David Currow, Kathy Eagar, Declan Walsh, Marian Conroy, Feargal Twomey, Val O’Reilly, Mairéad Doherty, Siobhain Coffey, John Sheridan, and Sue Moran published in Journal of Palliative Medicine, April 2020, Vol: 23, Issue 4. 535-541. http://doi.org/10.1089/jpm.2019.0295 Published online ahead of print: December 19, 2019.
EAPC MEMBERS RECEIVE DISCOUNT ON JOURNAL OF PALLIATIVE MEDICINE SUBSCRIPTIONS
As an official journal of the EAPC, ‘Journal of Palliative Medicine’ offers EAPC members a substantial discount on a personal online subscription, which includes unlimited access to the fully searchable archive of published articles. More information here.
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Links
- Contact Dr Mike Lucey by email.
- Milford Care Centre.
- Registered delegates to the EAPC 17th World Research Congress can view the presentation of the ‘Best European Paper of the Year’ here. Just login with your password. All congress content is available until 31 January 2022. Login here with your password.
- Access the EAPC 17th World Congress Abstracts, published in Palliative Medicine, vol: 34, issue 1, suppl, page(s):1-243. https://doi.org/10.1177/02692163211035909 (Open access).
- Read more posts about the EAPC World Congress here.
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