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Article: Early integrated palliative care for haematology cancer patients-the impact on symptom burden in Hong Kong

TitleEarly integrated palliative care for haematology cancer patients-the impact on symptom burden in Hong Kong
Authors
KeywordsEarly palliative care (early PC)
haematology palliative care
symptom burden
Issue Date2021
PublisherAME Publishing Company. The Journal's web site is located at http://apm.amegroups.com/
Citation
Annals of Palliative Medicine, 2021, v. 10 n. 6, p. 6316-6324 How to Cite?
AbstractBackground: Evidence showed that early palliative care could have many benefits in clinical outcomes for patients living with advanced medical illnesses. In fact, most of these studies have not involved patients with advanced haematologic cancer (HC), which are known to be associated with significant physical and psychological symptoms. In Hong Kong, an Early Integrated Palliative Care (EIPC) collaboration involving both Heamatology unit of Queen Mary Hospital (QMH) and the Palliative Medical Unit of Grantham Hospital (GH) has been started since early 2018 as a better way to improve the service gap. The HC patients failed 2 or more lines of cancer treatment are identified during the joint round and hematology clinic. Some of these patients will be referred to our PC services. Our joint PC clinic has multidisciplinary input from palliative care physicians, hematologists, and clinical psychologists. The clinic program is well coordinated and structured. The HC patients are initially seen by the parent team for disease treatment and then by GH PC team for symptom control and psychosocial care. Methods: This was a retrospective study with a review of the clinical charts and electronic healthcare records of all patients who attended the Hematology PC clinic from June 2018 to September 2020. For the inclusion criteria, patients were found eligible if they had prospectively completed Edmonton Symptom Assessment Scale (ESAS) assessments for at least the initial and follow-up visits within a range of ≥7 days and ≤60 days of the first visit. Results: Thirty-eight patients ultimately agreed to the referral. The mean age was 70.5 (12.5) years old. Twenty-five patients (66%) had myelodysplastic syndrome (MDS); 10 (26%) had acute myeloid leukemia (AML). Around 50–60% of patients reported significant symptoms of fatigue, anxiety, drowsiness, and anorexia; 42% of patients had significantly depressed moods while 37% had pain. There were significant symptom improvements for pain, depression, and anxiety after follow-up visits. Conclusions: The study showed that our EIPC program resulted in a significant reduction in some of the important symptom item scores, including pain, anorexia, anxiety, and depression, after the follow-up visits.
Persistent Identifierhttp://hdl.handle.net/10722/301483
ISSN
2020 Impact Factor: 2.595
2020 SCImago Journal Rankings: 0.546
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChan, KY-
dc.contributor.authorSingh, H-
dc.contributor.authorChan, TSY-
dc.contributor.authorLi, CW-
dc.contributor.authorTsang, KW-
dc.contributor.authorAu, HY-
dc.contributor.authorWong, CY-
dc.contributor.authorHui, CH-
dc.date.accessioned2021-07-27T08:11:45Z-
dc.date.available2021-07-27T08:11:45Z-
dc.date.issued2021-
dc.identifier.citationAnnals of Palliative Medicine, 2021, v. 10 n. 6, p. 6316-6324-
dc.identifier.issn2224-5820-
dc.identifier.urihttp://hdl.handle.net/10722/301483-
dc.description.abstractBackground: Evidence showed that early palliative care could have many benefits in clinical outcomes for patients living with advanced medical illnesses. In fact, most of these studies have not involved patients with advanced haematologic cancer (HC), which are known to be associated with significant physical and psychological symptoms. In Hong Kong, an Early Integrated Palliative Care (EIPC) collaboration involving both Heamatology unit of Queen Mary Hospital (QMH) and the Palliative Medical Unit of Grantham Hospital (GH) has been started since early 2018 as a better way to improve the service gap. The HC patients failed 2 or more lines of cancer treatment are identified during the joint round and hematology clinic. Some of these patients will be referred to our PC services. Our joint PC clinic has multidisciplinary input from palliative care physicians, hematologists, and clinical psychologists. The clinic program is well coordinated and structured. The HC patients are initially seen by the parent team for disease treatment and then by GH PC team for symptom control and psychosocial care. Methods: This was a retrospective study with a review of the clinical charts and electronic healthcare records of all patients who attended the Hematology PC clinic from June 2018 to September 2020. For the inclusion criteria, patients were found eligible if they had prospectively completed Edmonton Symptom Assessment Scale (ESAS) assessments for at least the initial and follow-up visits within a range of ≥7 days and ≤60 days of the first visit. Results: Thirty-eight patients ultimately agreed to the referral. The mean age was 70.5 (12.5) years old. Twenty-five patients (66%) had myelodysplastic syndrome (MDS); 10 (26%) had acute myeloid leukemia (AML). Around 50–60% of patients reported significant symptoms of fatigue, anxiety, drowsiness, and anorexia; 42% of patients had significantly depressed moods while 37% had pain. There were significant symptom improvements for pain, depression, and anxiety after follow-up visits. Conclusions: The study showed that our EIPC program resulted in a significant reduction in some of the important symptom item scores, including pain, anorexia, anxiety, and depression, after the follow-up visits.-
dc.languageeng-
dc.publisherAME Publishing Company. The Journal's web site is located at http://apm.amegroups.com/-
dc.relation.ispartofAnnals of Palliative Medicine-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectEarly palliative care (early PC)-
dc.subjecthaematology palliative care-
dc.subjectsymptom burden-
dc.titleEarly integrated palliative care for haematology cancer patients-the impact on symptom burden in Hong Kong-
dc.typeArticle-
dc.identifier.emailChan, KY: drkychan@hku.hk-
dc.identifier.emailSingh, H: gillhsh@hku.hk-
dc.identifier.emailLi, CW: bryanli@hku.hk-
dc.identifier.authoritySingh, H=rp01914-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.21037/apm-21-276-
dc.identifier.pmid34237956-
dc.identifier.scopuseid_2-s2.0-85108728802-
dc.identifier.hkuros323609-
dc.identifier.volume10-
dc.identifier.issue6-
dc.identifier.spage6316-
dc.identifier.epage6324-
dc.identifier.isiWOS:000694019900027-
dc.publisher.placeHong Kong-

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