title: Patients attended by palliative care teams: are they always comparable populations?
abstract: Patients attended by palliative care teams: are they always comparable populations? To answer this question we have compared the basic epidemiological characteristics of patients attended by home palliative care teams (HPCT) in two autonomous regions of Spain. We carried out a coordinated analytical, observational and prospective study in two Spanish autonomous regions: Aragon and Catalonia. Data were kept during each home care visit according to patients' needs. Inclusion criteria were: advanced cancer, over 18 years old and first contact with a HPCT. The recruitment period was 6 months. Variables included were: Survival time (days), age, sex, primary disease and extension, place of residence. Functional and cognitive state, and co-morbidity. 10 signs/symptoms: asthenia, anorexia, cachexia, dysphagia, xerostomy, dyspnoea, oedemas, level of consciousness, presence of delirium, presence of pressure ulcers and some treatment data. Others variables considered were: responsible team, origin, destination when discharge, date and place of death, number of visits made and duration of monitoring. We developed a comparison between groups by Chi-squared test or the non-parametric Mann-Whitney U test and a survival analysis by Kaplan-Meier curves and the logrank test to determine differences between factors. The SPSS version 15.0 software package was used. 698 patients were included, 56.2% from Aragon and 43.8% from Catalonia. 60.3% were males, without differences between the regions. Characteristics relative to age, sex, place of residence and extension of oncological diseases were similar for both groups. We found significant differences between the two populations relative to survival time, co-morbidity, functional state, presence and intensity of a number of symptoms and the treatments, patient monitoring and the their destination after discharge. We can conclude that palliative care teams cover different profiles of patients with regard to their co-morbidity, functional, cognitive and symptomatic states. It must be pointed that the organization of palliative care services and their experience appears to condition the profile of patients they attend. There is a need of consensus on the basic descriptors for palliative care patients in order to ensure that results will be comparable.
authors: Family and Community Medicine, Palliative Care Support Team, Arnau de Vilanova University Hospital, ICS Institut de Reserca Biomédica de Lleida (IRBL), Lleida, Spain ; Ufiss Cuidados Paliativos, Hospital Universitario Arnau de Vilanova, Av. Rovira Roure 80, Lleida, 25198 Spain.
authors: Maria
authors: M
authors: Nabal
authors: Miquel
authors: M
authors: Barcons
authors: Roberto
authors: R
authors: Moreno
authors: Xavier
authors: X
authors: Busquets
authors: Javier J
authors: JJ
authors: Trujillano
authors: Antonio
authors: A
authors: Requena
references: Palliat Support Care. 2004 Dec;2(4):419-23
references: 16594406
references: Lancet. 2011 Jan 8;377(9760):127-38
references: 21183212
references: Palliat Med. 2009 Jan;23(1):80-6
references: 18952752
references: J Pain Symptom Manage. 2009 Mar;37(3):305-15
references: 19268812
references: Palliat Med. 2007 Sep;21(6):461-2
references: 17846084
references: Palliat Med. 2000 Sep;14(5):387-94
references: 11064785
references: Lancet Oncol. 2011 May;12(5):489-95
references: 21296615
references: J Clin Oncol. 2009 Jun 20;27(18):3052-8
references: 19451437
references: Crit Rev Oncol Hematol. 2011 Oct;80(1):114-44
references: 21216616
references: J Pain Symptom Manage. 2009 Mar;37(3):373-86
references: 18809276
references: Palliat Med. 2010 Sep;24(6):641-50
references: 20395355
references: Med Care. 2000 May;38(5):528-41
references: 10800979
references: Palliat Med. 2009 Jun;23(4):295-308
references: 19286741
references: J Pain Symptom Manage. 2007 May;33(5):584-90
references: 17482052
references: N Engl J Med. 1996 Jul 18;335(3):172-8
references: 8657216
references: J Pain Symptom Manage. 2009 Mar;37(3):395-402
references: 18722748