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Palliative care pain control: inpatient consultation versus corounding models compared


Background Compared with the current inpatient consultation model, a novel corounding model of care whereby palliative specialists round with oncology teams, increases healthcare collaboration and may improve quality of care for inpatients. Whether this translates to better pain control for patients is unexplored.

Objective To determine whether the corounding model provides better pain control compared with the consultation model for cancer inpatients.

Methods Cancer patients with moderate or severe pain severity during the admission were included in this observational study. Pain severity was determined using electronic records. Improvement to mild or no pain by day 3 of identification of moderate or severe pain was defined as good pain control and proportion of admissions achieving this was compared between models.

Results A total of 142 and 128 admissions admitted under the consult and corounding model, respectively, had moderate or severe pain. The proportion of patients that achieved good pain control was 77.3% (99/128) and 71.8% (102/142) in the corounding and consult model, respectively. The difference in proportion of admissions achieving good pain control was significantly higher in the corounding model after adjusting for differences in baseline characteristics (unadjusted OR, 1.34; 95% CI, 0.77 to 2.33; adjusted OR, 2.25; 95% CI, 1.19 to 4.26).

Discussion The odds of achieving good pain control was significantly better in the corounding model. However, the mechanism behind this is unexplored. This study can serve as precedence for future studies evaluating the corounding model of care.

  • pain
  • cancer
  • hospital care
  • service evaluation

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