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The following is a summary of “Evaluating the Benefits of Transition to Home Palliative Care: Pharmacological Prescriptions, Social, and Psychological Support Post-Referral,” published in the November 2024 issue of Primary Care by Ribeiro et al.
Community palliative care teams provide at-home care based on referral criteria that prioritize functional status and clinical complexity. They focus on patients with limited benefit from continued hospital care.
Researchers conducted a retrospective study to assess the quality of referrals and the transition to community palliative care teams.
They conducted an observational, longitudinal, retrospective cohort study using clinical health records of patients who received community palliative care in 2023. Prior multidisciplinary follow-up, basic social support, medication changes were evaluated during the first consultation, and hospital emergency care recurrences. Data was collected from 200 patient files.
The results showed a mean patient age of 80.7 years (±11.92), with 56.3% males and a median follow-up of 32 days. Primary diagnoses were cancer (50%), end-stage organ failure (26%), and neurodegenerative disease (24%). Among the deceased, 85.6% died at home. Psychological support improved from 6.8% to 100% (P = .0011), and social rights support improved from 47.1% to 100% (P = .01). Pharmacotherapeutic plans changed significantly, with referrals often delayed, especially for those under hospital care (P = .001). Increased pro re nata prescriptions correlated with home deaths (P = .021).
They concluded that most complex patients were successfully monitored and died at home, with hospital deaths reserved for exceptional cases. There was no significant difference in the biopsychosocial approach between patients followed by various palliative care teams, indicating varying approaches.
Source: journals.sagepub.com/doi/full/10.1177/21501319241285340
