Background Enhanced Supportive Care (ESC) promotes the earlier implementation of supportive care within cancer care (Bakitas, Tosteson, Li, et al. J Clin Oncol. 2015;33(13):1438–1445; Bandieri, Banchelli, Artioli, et al. BMJ Support Palliat Care. 2020;10(4):e32; Monnery, Benson, Griffiths, et al. Int J Palliat Nurs. 2018; 24(10):510–514). Integration of care between Oncology and Palliative Care can improve patient outcomes and is increasingly recommended (Benson, Wong, Olsson-Brown, et al. Int J Palliat Nurs. 2023; 29(3):129–136; Monnery, Tredgett, Hooper, et al. Clin Oncol. 2023; 35(6):395–403). The Clatterbridge Cancer Centre has introduced an integrated ESC model within the mutation driven non-small cell lung cancer (NSCLC) clinic. This is a collaborative clinic between the Oncology and Palliative Care teams.
Aims To evaluate an integrated ESC model within lung cancer care. To assess the impact on patient outcomes and identify patient needs.
Methods 38 patients with NSCLC were supported by integrated ESC delivery in the first six months of the clinic. These patients had an IPOS score completed at initial review and at follow up. Data was collected retrospectively. This was used to assess longitudinal changes in Integrated Palliative Care Outcome Scale (IPOS) scores as indicators of quality of life (Cicely Saunders Institute. Integrated Palliative Care Outcome Score. 2012; Basch, Deal, Dueck, et al. JAMA. 2017; 318(2):197–198). A retrospective case control analysis was used to review other outcomes.
Results Patients seen by the ESC team experienced less severe symptoms over time. There were statistically significant improvements seen in dyspnoea, pain and the information needs of patients who were seen in the joint clinic.
Conclusion An integrated ESC model can be effective in improving outcomes for patients with NSCLC. This is a developing service and continued data collection will allow the ongoing impact on patient outcomes to be assessed.
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