Background For patients with chronic, life limiting haematological conditions such as Myelodysplastic syndrome (MDS), regular transfusion for relief of symptoms of anaemia requires frequent attendance to acute hospital. Literature demonstrates MDS is associated with significant impairment and poor prognosis with critical palliative care needs.1 Opportunities to address these needs can be challenging in an acute environment.
The Covid-19 pandemic led to a revision of services offered in St. Oswald’s Hospice Day Services with the development of a new Ambulatory Care service for patients requiring blood transfusion. This involves working with specialities to offer services to patients who would benefit from earlier palliative care support.
Method Following a successful pilot service we have continued to capture patient experience, patient need to access services available from palliative care MDT whilst working collaboratively with Haematology and Oncology services.
Records were kept of MDT services accessed alongside collated patient feedback.
Results From March to October 2021 there have been 13 patients with 86 attendances for blood transfusion:
All patients had initial assessment with a senior palliative medicine Doctor
5 patients have engaged in Advance Care Planning discussions
3 patients reviewed by Physiotherapy
6 patients received complementary therapy
1 patient reviewed by social worker
5 patients had medical review for specific symptom management
1 patient assessed by lymphoedema specialist
2 patients referred to music therapist
1 patient admitted to the inpatient unit for observation overnight
1 patient admitted for end of life care after outpatient attendance
Feedback has been very positive from patients and their families
Conclusion Patient feedback has been very positive with patients accessing palliative care services and engaging in ACP. Increasing the number of referrals to the service will continue to widen access to patients not typically referred until later in their disease process, promoting improved quality of life and Advance Care Planning.
Nickolich M, El-Jawahri A, LeBlanc TW. Palliative and end-of-life care in myelodysplastic syndromes. Curr Hematol Malig Rep 2016;11:434–440.
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