title: Referrals of cancer versus non-cancer patients to a palliative care consult team: do they differ?
abstract: This retrospective study compared 100 consecutive non-cancer (NC) patients referred to a palliative care consult team (PCT) in a Swiss university hospital to 506 cancer (C) patients referred during the same period. The frequencies of reported symptoms were similar in both groups. The main reasons for referral in the NC group were symptom control, global evaluation, and assistance with discharge. Requests for symptom control predominated in the C group. Prior to the first visit, 50% of NC patients were on opioids, compared to 58% of C patients. After the first visit, the proportion of NC patients on opioids increased to 64% and the proportion of C patients to 73%. The median daily oral morphine equivalent dose for NC patients taking opioids prior to the first PCT visit was higher than that for C patients (60 mg versus 45 mg). At the time of death or discharge, the percentage of NC patients on opioids was 64%, while that of C patients was 76%. Moreover, NC patients were on significantly lower median doses of opioids than C patients (31 mg versus 60 mg). Over half the NC patients died during hospitalization, as compared to 33% of C patients. Only 6% of NC patients were discharged to palliative care units, as compared to 22% of C patients.
authors.affiliation: Palliative Care Service, Department of Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: Boris
authors.initials: B
authors.lastname: Cantin
authors.forename: Laura E
authors.initials: LE
authors.lastname: Rothuisen
authors.forename: Thierry
authors.initials: T
authors.lastname: Buclin
authors.forename: José
authors.initials: J
authors.lastname: Pereira
authors.forename: Claudia
authors.initials: C
authors.lastname: Mazzocato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid; D002318:Cardiovascular Diseases / Q000628:therapy; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy; D009422:Nervous System Diseases / Q000628:therapy; D010166:Palliative Care / Q000379:methods / Q000706:statistics & numerical data*; D012017:Referral and Consultation; D012189:Retrospective Studies; D013557:Switzerland
chemical_list: D000701:Analgesics, Opioid