Background Evidence suggests early palliative care involvement (PCI) alongside oncology care improves quality of life, planning and communication for advanced cancer patients. Previous work in Cornwall suggested COPC reduced number and length of hospital admissions in oncology patients with varied cancer diagnoses. This study examines findings in lung cancer patients.
Methods Baseline data was collected for fifty-nine patients attending lung cancer COPC or Standard Oncology Clinic (SOC), including (but not limited to) mortality rates, average survival of those who died, performance status, and stage of disease. Over 12 months from initial oncology or palliative medicine consultant contact, rates of hospital admissions, length of stay, reasons for admission, and preferred place of discharge were recorded.
Results Background data suggested there was little difference in the baseline data for patients attending the 2 clinic types, except that performance status was somewhat worse for the COPC group (ECOG for COPC patients 1=19, 4=8, versus SOC 1=25, 4=2 with ECOG 2 and 3 same number each group). Mortality rates were similar. Of deaths, survival was 4.82 months COPC versus 5.33 SOC. COPC patients had 56 hospital admissions, and SOC 49. Average Length of stay was similar across the 2 groups. Reason for admission differed between the 2 groups: COPC/SOC complication of disease (60.7% versus 44.9%) COPC/SOC complication of treatment (12.5% versus 38.8%). COPC recorded Preferred Place of Discharge in 37.3% of admissions versus SOC 18.6%. Rates of achievement were similar. COPC recorded other advance care planning in 41.0% patients versus 10.2% SOC.
Conclusions In lung cancer patients rates of hospital admissions and LOS were not reduced by COPC input, but reasons for admission were different. Despite poorer performance status results there was no difference in the average number of months survival of those who died within the 12 months analysed.
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