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01-05-2024 | Research

Characteristics of timely integration of palliative care into oncology hospital care for patients with incurable cancer: results of a Delphi Study

Authors: Carly S. Heipon, Linda Brom, Yvette M. van der Linden, Dorien Tange, Anna K. L. Reyners, Natasja J. H. Raijmakers

Published in: Supportive Care in Cancer | Issue 5/2024

Abstract

Purpose

To identify elements of timely integration of palliative care (PC) into hospital oncology care from best practices. Thereafter, to assess the level of consensus among oncology and PC specialists and patient and relative representatives on the characteristics of timely integration of PC.

Methods

A three-round modified Delphi study was conducted. The expert panel consisted of 83 healthcare professionals (HCPs) from 21 Dutch hospitals (43 physicians, 40 nurses), 6 patient and 2 relative representatives. In the first round, four elements of integrated PC were considered: (1) identification of potential PC needs, (2) advance care planning (ACP), (3) routine symptom monitoring and (4) involvement of the specialist palliative care team (SPCT). In subsequent rounds, the panellists assessed which characteristics were triggers for initiating an element. A priori consensus was set at ≥ 70%.

Results

A total of 71 (78%) panellists completed the first questionnaire, 65 (71%) the second and 49 (54%) the third. Panellists agreed that all patients with incurable cancer should have their PC needs assessed (97%), symptoms monitored (91%) and ACP initiated (86%). The SPCT should be involved at the patient’s request (86%) or when patients suffer from increased symptom burden on multiple dimensions (76%). Patients with a life expectancy of less than 3 months should be offered a consultation (71%).

Conclusion

The expert panel agreed that timely integration of PC into oncology is important for all patients with incurable cancer, using early identification, ACP and routine symptom monitoring. Involvement of the SPCT is particularly needed in patients with multidimensional symptom burden and in those nearing death.

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Title: Characteristics of timely integration of palliative care into oncology hospital care for patients with incurable cancer: results of a Delphi Study
Authors: Carly S. Heipon
Linda Brom
Yvette M. van der Linden
Dorien Tange
Anna K. L. Reyners
Natasja J. H. Raijmakers
Publication date: 01-05-2024
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 5/2024
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-024-08508-0

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