Effectiveness of palliative care in late-stage lung cancer compared with standard care, Chiangrai Prachanukroh Hospital
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Abstract
Background: Palliative care is effective in caring for patients under life-threatening conditions, improving the quality of life for patients and their families, reducing medical expenses, and increasing service satisfaction. However, there have been no recent studies on the effectiveness of palliative care in patients with late-stage lung cancer at Chiangrai Prachanukroh Hospital. This study aimed to enhance operational efficiency and increase patient care potential at the hospital's palliative care center.
Objective: To Compare the effectiveness of palliative care in patients with late-stage lung cancer with standard care.
Methods: This retrospective cohort study analyzed patients with late-stage lung cancer treated at Chiangrai Prachanukroh Hospital who passed away during the fiscal year 2021–2022. The subject included 214 cases, divided into 170 cases in the palliative group and a standard group bout 44 cases without palliative care consultation. Outcomes were compared, including symptom assessment, receipt of strong opioids, participating in family conferences, ICU admissions, deaths at preferred locations, and last direct medical costs before death.
Results: The palliative care group received effectively assessed and managed symptoms compared to the standard group (p < 0.001). They received strong opioids for pain control more frequently than the standard group and underwent fewer invasive procedures, such as endotracheal intubation, defibrillation, inotropic support, and ICU admissions. The palliative care group engaged in advance care planning and family conferences more often than the standard group.
The places of death of patients in both groups were significantly different. Most of the patients in the palliative care group (57.40%) died in their preferences place, meanwhile, the majority (84.09%) of the standard care did not decide on the place of death. Direct medical expenses during the last admission in the palliative group decreased by 9,005.94 Baht compared to the standard group.
Conclusions and recommendations: Palliative care for late-stage lung cancer patients is effective in evaluating and managing distressing symptoms with strong opioids, planning care, and allowing patients to choose their preferred place of death. Therefore, it is imperative to further implement the palliative care model for this particular cohort of patients.
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