Impact of palliative care consultation service on terminally ill cancer patients: A 9-year observational cohort study in Taiwan

Ching Yi Lu, Wen Chi Shen, Chen Yi Kao, Hung Ming Wang, Shu Chuan Tang, Tsu Ling Chin, Chuan Chuan Chi, Jin Mei Yang, Chih Wen Chang, Ying Fen Lai, Ya Chi Yeh, Yu Shin Hung, Wen Chi Chou*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

17 Scopus citations

Abstract

The palliative care consultation service (PCCS) that has been enthusiastically promoted in Taiwan since 2005 was designed to provide comprehensive end-of-life care for terminally ill patients with qualified interdisciplinary specialists in acute care ward setting. This study aims to evaluate the impact of PCCS on terminally ill cancer patients. A total of 10,594 terminal cancer patients who were referred to PCCS from a single medical center in Taiwan between 2006 and 2014 were enrolled. The percentages of patients' and their families' disease awareness, do-not-resuscitate (DNR) designation, refusal and acceptance of palliative care among terminally ill cancer patients were analyzed retrospectively. At the beginning of PCCS, the percentages of disease awareness among patients and their family were increased from 25.4% to 37.9% (P=0.007) and from 61.2% to 84.7% between 2006 and 2014 (P=0.001), respectively. Patients' disease awareness after PCCS referral between 2006 and 2014 was increased from47.1%to 64.5%(P=0.016). Family's awareness of diagnosis and prognosis after PCCS referral researched to a steady plateau, 94.1% to 97.8% in different year cohort (P=0.34). The percentage of DNR designation rate at the beginning of PCCS (in 2006) was 15.5%, and the designation rate was increased annually and finally reached to 42.0% in 2014 (P=0.004). The percentage ofDNR consents after PCCSwas also improved from44.0% in 2006 up to 80.0% in 2014 (P=0.005). PCCS refusal rate decreased gradually and dropped to 1.6% in 2014 (P=0.005). The percentage of PCCS utilization was increased 5-fold during the 9-year period after the promotion of PCCS In the program of PCCS promotion, an increasing trend of PCCS utilization, better patients' and their families' awareness of diagnosis and prognosis, more consent to DNR, more patients were discharged with stable condition at the end of PCCS and a decrease refusal rate of end-oflife palliative care among terminal cancer patients were observed in Taiwan between 2006 and 2014.

Original languageEnglish
Article numbere2981
JournalMedicine (United States)
Volume95
Issue number10
DOIs
StatePublished - 04 03 2016

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Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.

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