Advanced Cancer
Conditions
Keywords
early palliative care, referral
Brief summary
Early palliative care (EPC) in the clinical pathway of advanced cancer patients improves symptom control, quality of life and has a positive impact on overall quality of care. EPC contributes to realistic and attainable goals of treatment, facilitating patient choices, favouring adequate communication with patients and families and assessing patient values and preferences with regard to advance care planning. EPC is likely to promote a more appropriate use of health care resources and less aggressive cancer treatment in the last weeks of life. At present standardised criteria for appropriate referral for EPC in oncology outpatients setting are lacking. Therefore the aim of this project is to identify referral criteria and procedures to implement appropriate EPC for advanced patients (the Palliative Care Referral System) and test them in a pre-post experimental design evaluating their impact on quality of care and on the use of healthcare resources. A quasi-experimental, longitudinal, pretest-posttest study will be carried out. Two different cohorts of 150 advanced cancer patients each will be enrolled before (pretest) and after (posttest) the introduction of the PCRS in outpatient clinics of a Comprehensive Cancer Centre. Eligible patients will undergo patient-reported outcome measure (PROMs) evaluation at baseline and then monthly for at least 6 months from enrollment or till death. Use health care resources and quality of care indicators will be collected monthly by a dedicated research nurse.
Detailed description
As above.
Interventions
OTHERPalliative Care Referral System - PCRS
Implementation of a system to help oncologists to identify criteria for referring patients to specialized outpatient palliative care (Palliative Care Referral System - PCRS)
Sponsors
Fondazione IRCCS Istituto Nazionale dei Tumori, Milano
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
A quasi-experimental, longitudinal, pretest-posttest study will be carried out. Two different cohorts of 150 advanced cancer patients each will be enrolled before (pretest) and after (posttest) the introduction of the PCRS in outpatient clinics.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* age \>18 years; * recent diagnosis of inoperable locally advanced and/or metastatic cancer not eligible to anticancer treatment with curative intent;
Exclusion criteria
* cognitive impairment that would prevent self-assessments * current palliative care treatment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| patient reported experience | through study completion, up to 6 months | patient satisfaction with care, measured with the FAMCARE-P13 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| caregiver experience of care | through study completion, up to 6 months | Family Care Satisfaction scale (FAMCARE) |
| Activation of a Palliative Care service | through study completion, up to 6 months | Number of regular outpatient Palliative Care visits |
| Health related quality of life | through study completion, up to 6 months | European Organisation for Research and Treatment of Cancer - Quality of Life -Palliative Care questionnaire (Eortc QLQC15-PAL) |
| Hospitalization | through study completion, up to 6 months | Number of hospitalizations |
| Emergency department accesses | through study completion, up to 6 months | Number of accesses in Emergency departement |
| Multidisciplinary team visits | through study completion, up to 6 months | Number of multidisciplinary team visits (Oncology and Palliative Care) |
Countries
Italy
Outcome results
None listed