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Implementation of palliative care day hospital for outpatients with advanced cancer
  1. Laura Thery1,2,
  2. Matthieu de Stampa2,3,
  3. Alexis Burnod1,
  4. Romain Seban1,
  5. Céline Laouisset1,
  6. Timothée Marchal1 and
  7. Carole Bouleuc1
  1. 1Palliative Care Department, Institut Curie, Paris, France
  2. 2INSERM, CESP U1018, Paris-Saclay University, Gif-sur-Yvette, France
  3. 3Gerontology Department, Centre Gerontologique Departemental, Marseille, France
  1. Correspondence to Dr Laura Thery, Institut Curie, 26 rue d'Ulm, 75005, Paris, France; Laura.thery{at}curie.fr

Abstract

Objectives To describe the population of a palliative care day hospital (PCDH) in oncology and analyse the end-of-life trajectory.

Methods Monocentric retrospective cohort study of all referred patients for the first time to PCDH over an 8-month period with the data collected in all PCDH in their pathway care.

Results 116 patients were included for 319 stays in PCDH. At first referral PCDH, 62 (53.4%) patients had ongoing anticancer therapy. Twenty-four (20.7%) and 63 (54.3%) patients were in an unstable and deteriorating phase, respectively. Mean (SD) Eastern Cooperative Oncology Group performance status score was 2.8 (0.7). Mean (SD) stay per patient was 2.8 (2.2). For all stays, mean (SD) of joint intervention of palliative care team and oncologist was 1.2 (1.2) per patient. Mean (SD) of technical acts performed was 0.2 (0.6) per patient. Among the 109 deceased patients, 16 patients (14.7%) and 7 patients (6.4%) had received chemotherapy in the last month and 15 days before death, respectively.

Conclusion Our PCDH is a suitable place for a complex population still living at home. The reported patients’ demographics and PCDH’s organisation lead to a hybrid outpatient intervention between outpatient clinics and hospice care services. A randomised multicentric trial is ongoing to explore the impact of PCDH on patients’ trajectory and the use of resources.

  • symptoms and symptom management
  • terminal care

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Footnotes

  • Contributors Study concept and design—LT and CB. Data acquisition, statistical analysis and data interpretation—LT. Manuscript editing—LT. Manuscript review—LT, MdS, AB, RS, CL, TM and CB. All authors approved the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.