Background This abstract is taken from an article that was under review by International Journal of Palliative Nursing which was accepted for publication in late November 2022. At present, the article is in press. Integration of care between palliative care and oncology offers improvement in patient outcome and is increasingly recommended. There is evidence of improved patient and healthcare outcomes including quality of life, tolerability of systemic anticancer treatment in the last year of life and reduced healthcare cost. Alongside discussions of early palliative care integration, supportive care and its integration into oncology care has also come into focus. Supportive care is the prevention and management of the adverse effects of cancer and its treatment, including management of physical and psychological symptoms associated with cancer, its treatment and associated post-treatment care. Enhanced Supportive Care (ESC), led and delivered by palliative care clinical nurse specialists is a potential model to achieve this but is currently unevidenced.
Aim To investigate the impact of a nurse-led integrated ESC model within the hepatopancreatobiliary (HPB) cancer care setting
Method One-hundred and one patients with HPB cancer were supported by integrated ESC delivered within a co-located clinic structure. Data relating to symptoms and quality of life were collected prospectively. Survival data and chemotherapy usage was retrospectively analysed following minimum follow-up, utilising a matched control technique.
Results ESC patients illustrated improvements in certain key symptoms including pain, nausea, vomiting and mood over time. Patients also had less aggressive treatment towards the end of life amounting to 31% less chemotherapy than controls with comparable survival.
Conclusion An integrated nurse-led ESC model can be effective in improving outcomes for patients with HPB cancer. This model resulted in improved quality of life and a reduction in the amount of chemotherapy administered in the last year of life with comparable survival.
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