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  • 39 Does early integration of palliative care with acute oncology services improve cancer patient outcomes following acute hospital admission? A rapid review

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Changing policy and practice
39 Does early integration of palliative care with acute oncology services improve cancer patient outcomes following acute hospital admission? A rapid review
  1. Mala Mann1,2,
  2. Lowri Evans3,
  3. Lucy Williams4 and
  4. Anthony Byrne2
  1. 1Specialist Unit for Review Evidence (SURE), University Library Service, Cardiff University, UK
  2. 2Marie Curie Palliative Care Research Centre, Division of Population Medicine, School of Medicine, Cardiff University, UK
  3. 3Cwm Taf Morgannwg University Health Board, Navigation Park, Unit 3 Ynysmeurig House, Abercynon, UK
  4. 4Aneurin Bevan University Health Board, Victoria House, Newport, UK

Abstract

Introduction Cardiff and Vale tertiary care and cancer centre services are currently developing a 10-year strategy for support of cancer patients in acute settings. An important aim is to understand how Specialist Palliative Care Teams (SPCTs) and Acute Oncology Services (AOS) can, together, best support acutely admitted patients to receive the right care, in the right place, at the right time.

Aims To identify models for early palliative care integrated with AOS in hospital setting to improve patient outcomes.

Method Six key databases were searched for papers published between 2011-2021. Supplementary searches were also conducted. We followed Palliative Care Evidence Review Service (PaCERS) methodology,1 developed to conduct rapid reviews requested by clinicians/clinical services.

Results No studies examined integrated working with AOS. However, six studies out of seven publications met inclusion criteria for assessing impact of standalone palliative care for cancer patients in acute settings. Two studies primarily focused on direct patient reported outcomes such as quality of life or symptom burden. Four studies focused mainly on economic outcomes such as length of stay, readmission rates, cost, and subsequent treatments. There is some evidence that palliative care consultation reduced readmission rates, increased hospice use and reduced chemotherapy post discharge.

Conclusion There was no evidence for specific integrated models of AOS and SPCT, and none of the studies were UK based. Reliability of evidence was variable.

However, the findings highlight potential gains for integrated models of AOS and Specialist Palliative Care for both patient outcomes and resource use. Future studies with more robust methodology should focus on patient experience and cost effectiveness of combined AOS and SPCT intervention in UK settings.

Reference

  1. Mann M, Woodward A, Nelson A, Byrne A. Palliative care evidence review service (PaCERS): a knowledge transfer partnership. Health Research Policy and Systems 2019;17(1):100. doi:10.1186/s12961-019-0504-4

Impact Review findings will be used to inform local health board strategy and delivery plans.

http://dx.doi.org/10.1136/spcare-2021-MCRC.39

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