Cargando…

Engagement, Advance Care Planning, and Hospice Use in a Telephonic Nurse-Led Palliative Care Program for Persons Living with Advanced Cancer

SIMPLE SUMMARY: Persons living with advanced cancer have significant symptoms and psychosocial needs that often result in visits to the Emergency Department. We enrolled persons living with advanced cancer in a 6-month program to receive telephone calls from nurses to help manage their symptoms, coo...

Descripción completa

Detalles Bibliográficos
Autores principales: Liddicoat Yamarik, Rebecca, Chiu, Laraine Ann, Flannery, Mara, Van Allen, Kaitlyn, Adeyemi, Oluwaseun, Cuthel, Allison M., Brody, Abraham A., Goldfeld, Keith S., Schrag, Deborah, Grudzen, Corita R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10136814/
https://www.ncbi.nlm.nih.gov/pubmed/37190238
http://dx.doi.org/10.3390/cancers15082310
_version_ 1785032309528854528
author Liddicoat Yamarik, Rebecca
Chiu, Laraine Ann
Flannery, Mara
Van Allen, Kaitlyn
Adeyemi, Oluwaseun
Cuthel, Allison M.
Brody, Abraham A.
Goldfeld, Keith S.
Schrag, Deborah
Grudzen, Corita R.
author_facet Liddicoat Yamarik, Rebecca
Chiu, Laraine Ann
Flannery, Mara
Van Allen, Kaitlyn
Adeyemi, Oluwaseun
Cuthel, Allison M.
Brody, Abraham A.
Goldfeld, Keith S.
Schrag, Deborah
Grudzen, Corita R.
author_sort Liddicoat Yamarik, Rebecca
collection PubMed
description SIMPLE SUMMARY: Persons living with advanced cancer have significant symptoms and psychosocial needs that often result in visits to the Emergency Department. We enrolled persons living with advanced cancer in a 6-month program to receive telephone calls from nurses to help manage their symptoms, coordinate care, and explore their values and goals for future care (advance care planning). About half of the subjects completed the 6-month program, a quarter died or enrolled in hospice, 19% were lost to follow-up, and 9% withdrew from the program. White patients and those with fewer symptoms were more likely to withdraw. Eighty-three percent of all patients completed some advance care planning, and 80% of patients received hospice care prior to death. ABSTRACT: Persons living with advanced cancer have intensive symptoms and psychosocial needs that often result in visits to the Emergency Department (ED). We report on program engagement, advance care planning (ACP), and hospice use for a 6-month longitudinal nurse-led, telephonic palliative care intervention for patients with advanced cancer as part of a larger randomized trial. Patients 50 years and older with metastatic solid tumors were recruited from 18 EDs and randomized to receive nursing calls focused on ACP, symptom management, and care coordination or specialty outpatient palliative care (ClinicialTrials.gov: NCT03325985). One hundred and five (50%) graduated from the 6-month program, 54 (26%) died or enrolled in hospice, 40 (19%) were lost to follow-up, and 19 (9%) withdrew prior to program completion. In a Cox proportional hazard regression, withdrawn subjects were more likely to be white and have a low symptom burden compared to those who did not withdraw. Two hundred eighteen persons living with advanced cancer were enrolled in the nursing arm, and 182 of those (83%) completed some ACP. Of the subjects who died, 43/54 (80%) enrolled in hospice. Our program demonstrated high rates of engagement, ACP, and hospice enrollment. Enrolling subjects with a high symptom burden may result in even greater program engagement.
format Online
Article
Text
id pubmed-10136814
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-101368142023-04-28 Engagement, Advance Care Planning, and Hospice Use in a Telephonic Nurse-Led Palliative Care Program for Persons Living with Advanced Cancer Liddicoat Yamarik, Rebecca Chiu, Laraine Ann Flannery, Mara Van Allen, Kaitlyn Adeyemi, Oluwaseun Cuthel, Allison M. Brody, Abraham A. Goldfeld, Keith S. Schrag, Deborah Grudzen, Corita R. Cancers (Basel) Article SIMPLE SUMMARY: Persons living with advanced cancer have significant symptoms and psychosocial needs that often result in visits to the Emergency Department. We enrolled persons living with advanced cancer in a 6-month program to receive telephone calls from nurses to help manage their symptoms, coordinate care, and explore their values and goals for future care (advance care planning). About half of the subjects completed the 6-month program, a quarter died or enrolled in hospice, 19% were lost to follow-up, and 9% withdrew from the program. White patients and those with fewer symptoms were more likely to withdraw. Eighty-three percent of all patients completed some advance care planning, and 80% of patients received hospice care prior to death. ABSTRACT: Persons living with advanced cancer have intensive symptoms and psychosocial needs that often result in visits to the Emergency Department (ED). We report on program engagement, advance care planning (ACP), and hospice use for a 6-month longitudinal nurse-led, telephonic palliative care intervention for patients with advanced cancer as part of a larger randomized trial. Patients 50 years and older with metastatic solid tumors were recruited from 18 EDs and randomized to receive nursing calls focused on ACP, symptom management, and care coordination or specialty outpatient palliative care (ClinicialTrials.gov: NCT03325985). One hundred and five (50%) graduated from the 6-month program, 54 (26%) died or enrolled in hospice, 40 (19%) were lost to follow-up, and 19 (9%) withdrew prior to program completion. In a Cox proportional hazard regression, withdrawn subjects were more likely to be white and have a low symptom burden compared to those who did not withdraw. Two hundred eighteen persons living with advanced cancer were enrolled in the nursing arm, and 182 of those (83%) completed some ACP. Of the subjects who died, 43/54 (80%) enrolled in hospice. Our program demonstrated high rates of engagement, ACP, and hospice enrollment. Enrolling subjects with a high symptom burden may result in even greater program engagement. MDPI 2023-04-15 /pmc/articles/PMC10136814/ /pubmed/37190238 http://dx.doi.org/10.3390/cancers15082310 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Liddicoat Yamarik, Rebecca
Chiu, Laraine Ann
Flannery, Mara
Van Allen, Kaitlyn
Adeyemi, Oluwaseun
Cuthel, Allison M.
Brody, Abraham A.
Goldfeld, Keith S.
Schrag, Deborah
Grudzen, Corita R.
Engagement, Advance Care Planning, and Hospice Use in a Telephonic Nurse-Led Palliative Care Program for Persons Living with Advanced Cancer
title Engagement, Advance Care Planning, and Hospice Use in a Telephonic Nurse-Led Palliative Care Program for Persons Living with Advanced Cancer
title_full Engagement, Advance Care Planning, and Hospice Use in a Telephonic Nurse-Led Palliative Care Program for Persons Living with Advanced Cancer
title_fullStr Engagement, Advance Care Planning, and Hospice Use in a Telephonic Nurse-Led Palliative Care Program for Persons Living with Advanced Cancer
title_full_unstemmed Engagement, Advance Care Planning, and Hospice Use in a Telephonic Nurse-Led Palliative Care Program for Persons Living with Advanced Cancer
title_short Engagement, Advance Care Planning, and Hospice Use in a Telephonic Nurse-Led Palliative Care Program for Persons Living with Advanced Cancer
title_sort engagement, advance care planning, and hospice use in a telephonic nurse-led palliative care program for persons living with advanced cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10136814/
https://www.ncbi.nlm.nih.gov/pubmed/37190238
http://dx.doi.org/10.3390/cancers15082310
work_keys_str_mv AT liddicoatyamarikrebecca engagementadvancecareplanningandhospiceuseinatelephonicnurseledpalliativecareprogramforpersonslivingwithadvancedcancer
AT chiularaineann engagementadvancecareplanningandhospiceuseinatelephonicnurseledpalliativecareprogramforpersonslivingwithadvancedcancer
AT flannerymara engagementadvancecareplanningandhospiceuseinatelephonicnurseledpalliativecareprogramforpersonslivingwithadvancedcancer
AT vanallenkaitlyn engagementadvancecareplanningandhospiceuseinatelephonicnurseledpalliativecareprogramforpersonslivingwithadvancedcancer
AT adeyemioluwaseun engagementadvancecareplanningandhospiceuseinatelephonicnurseledpalliativecareprogramforpersonslivingwithadvancedcancer
AT cuthelallisonm engagementadvancecareplanningandhospiceuseinatelephonicnurseledpalliativecareprogramforpersonslivingwithadvancedcancer
AT brodyabrahama engagementadvancecareplanningandhospiceuseinatelephonicnurseledpalliativecareprogramforpersonslivingwithadvancedcancer
AT goldfeldkeiths engagementadvancecareplanningandhospiceuseinatelephonicnurseledpalliativecareprogramforpersonslivingwithadvancedcancer
AT schragdeborah engagementadvancecareplanningandhospiceuseinatelephonicnurseledpalliativecareprogramforpersonslivingwithadvancedcancer
AT grudzencoritar engagementadvancecareplanningandhospiceuseinatelephonicnurseledpalliativecareprogramforpersonslivingwithadvancedcancer
AT engagementadvancecareplanningandhospiceuseinatelephonicnurseledpalliativecareprogramforpersonslivingwithadvancedcancer