Interventions and symptom relief in hospital palliative cancer care: results from a prospective longitudinal study

• Published in: Supportive care in cancer Vol. 29; no. 11; pp. 6595 - 6603
• Main Authors: Thronæs, Morten, Løhre, Erik Torbjørn, Kvikstad, Anne, Brenne, Elisabeth, Norvaag, Robin, Aalberg, Kathrine Otelie, Moen, Martine Kjølberg, Jakobsen, Gunnhild, Klepstad, Pål, Solberg, Arne, Solheim, Tora Skeidsvoll
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-11-2021; Springer; Springer Nature B.V
• Subjects: Adult; Antibiotics; Anxiety; Cancer; Cancer therapies; Constipation; Dyspnea; Fatigue; Health aspects; Hospital patients; Hospitalization; Hospitals; Humans; Hydration; Infant, Newborn; Inpatient care; Longitudinal Studies; Medicine; Medicine & Public Health; Mental depression; Narcotics; Nausea; Neoplasms - complications; Neoplasms - therapy; Nursing; Nursing Research; Oncology; Oncology, Experimental; Opioids; Original; Original Article; Pain management; Pain Medicine; Palliative Care; Prospective Studies; Rehabilitation Medicine; Sleep disorders; Symptom development; Acute palliative care unit (APCU); Integration; Palliative; Symptoms; Cancer
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-021-06248-z

Purpose
To study the use of interventions and symptom relief for adult patients with incurable cancer admitted to an acute palliative care unit providing integrated oncology and palliative care services.
Methods
All admissions during 1 year were assessed. The use of interventions was evaluated for all hospitalizations. Patients with assessments for worst and average pain intensity, tiredness, drowsiness, nausea, appetite, dyspnea, depression, anxiety, well-being, constipation, and sleep were evaluated for symptom development during hospitalization. Descriptive statistics was applied for the use of interventions and the paired sample
t
-test to compare symptom intensities (SIs).
Results
For 451 admissions, mean hospital length of stay was 7.0 days and mean patient age 69 years. More than one-third received systemic cancer therapy. Diagnostic imaging was performed in 66% of the hospitalizations, intravenous rehydration in 45%, 37% received antibiotics, and 39% were attended by the multidisciplinary team. At admission and at discharge, respectively, 55% and 44% received oral opioids and 27% and 45% subcutaneous opioids. For the majority, opioid dose was adjusted during hospitalization. Symptom registrations were available for 180 patients. Tiredness yielded the highest mean SI score (5.6, NRS 0–10) at admission and nausea the lowest (2.2). Significant reductions during hospitalization were reported for all assessed SIs (
p
 ≤ 0.01). Patients receiving systemic cancer therapy reported symptom relief similar to those not on systemic cancer therapy.
Conclusion
Clinical practice and symptom relief during hospitalization were described. Symptom improvements were similar for oncological and palliative care patients.