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Feasibility Study of the care pathway checklist (CPCL) for palliative care interventions (PCIs) delivered by oncologists in routine care

D. Mosoiu , M. Groza , N Magayakalbermatten, Mary Helen Schmidt , R. Curca , A. Grigorescu , V. Poroch , G. Rahnea , Franzisca Domeisen Benedetti, P. Achimas & Florian Strasser

abstract Background: Early specialized palliative care (sPC)
documents benefits in nord american settings, but in
ressource-variable european countries often lacking a SPC
workforce clinical practice tools (CPT) for oncology health care
professionals (O-HCPs) may be efficient to address cancer
patients (pts) unmet needs for PCIs.
Aim: to develop and test a CPT to screen for and deliver PCIs
by O-HCPs.
Methods: Prospective 2-week multicenter feasibility study in
out-and inpatient units of consecutive pts (PS 1–3, normal
cognition, advanced incurable cancer).
Screening: 6 predefined questions on palliative needs, rESAS
(Romanian language).
Intervention: weekly needs-tailored and institution adapted
CPCL with defined 7 PCIs (illness/prognosis understanding,
symptom management, chemotherapy preference/decision,
family care, networking, end-of-life worries, spirituality).
Outcomes: rESAS change in 2 weeks (Paired-samples t-tests), relation of number of CPCL (0–7) and rESAS change (Binary
logistic regressions), specific CPCL and individual symptom
improvement (Pearson’s Chi-squared tests).
Results: In 81 pts (median age 59, 48.1% female) from 6
romanian centres pain (t76=2.68, p=.009), fatigue
(t76=3.40, p=.001), anxiety (t73=2.33, p=.023), depression
(t71=3.60, p=.001), dyspnea (t76=2.27, p=.026), appetite
(t76=3.30, p=.001) and somnolence (t76=2.29, p=.025)
were significantly reduced. Using more CPCL was a significant
predictor of improved mood. Improvement (all n=81) of pain
was associated with illness/ prognosis (Χ2=7.60, p=.006),
chemotherapy (Χ2=10.42, p=.001), and symptom
management (Χ2=6.24, p=.012) CPCL; of nausea (n=81) with
chemotherapy (Χ2=5.26, p=.022) CPLC, and of appetite with
symptom management (Χ2= 5.56, p=.018) CPCL.
Conclusion: The application of a pragmatic screening and
CPCL to deliver advanced cancer pts needs-based defined
PCIs seems feasible and effective for symptom control.
Further research may explore change of pts needs and a realworld
randomized trial
   
citation Mosoiu D, Groza M, magayakalbermatten n, Schmidt M H, Curca R, Grigorescu A, Poroch V, Rahnea G, Domeisen Benedetti F, Achimas P, & Strasser F (2017). Feasibility Study of the care pathway checklist (CPCL) for palliative care interventions (PCIs) delivered by oncologists in routine care. In European Journal of Palliative Care (pp. 1130). Italy: European Association for Palliative Care.
   
type conference paper/poster (English)
name of conference EAPC Congress (Madrid)
date of conference 18-5-2017
title of proceedings European Journal of Palliative Care
pages 1130
publisher European Association for Palliative Care (Italy)
contact Franzisca Domeisen Benedetti