Trend analysis of palliative care consultation service for terminally ill non-cancer patients in Taiwan: a 9-year observational study

BMC Palliative Care

Pi-Shan Hsu¹  Lung-Chun Lee¹  Chung-Chieh Hu¹  Wei-Min Chu²  Chun-Li Wang³  Ling-Hui Huang⁴  Lian-Shin Lin⁴  Yu-Chen Chang⁵ 

[1] Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan;Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan;Department of Occupational Medicine, Taichung Veterans General Hospital, Taichung, Taiwan;School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;School of Medicine, Chung Shan Medical University, Taichung, Taiwan;Institue of Health Policy and Management, National Taiwan University, Taipei, Taiwan;Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan;Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan;Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan;Technology Transfer and Incubation Center, National Health Research Institutes, Miaoli, Taiwan;

关键词: Palliative care consultation service;    Non-cancer;    Do-not-resuscitate;    Awareness;   

DOI  :  10.1186/s12904-021-00879-z

来源: Springer

【 摘 要 】

BackgroundsEarly integration of palliative care for terminally ill non-cancer patients improves quality of life. However, there are scanty data on Palliative Care Consultation Service (PCCS) among non-cancer patients.MethodsIn this 9-year observational study Data were collected from the Hospice-Palliative Clinical Database (HPCD) of Taichung Veterans General Hospital (TCVGH). Terminally ill non-cancer patients with 9 categories of diagnoses who received PCCS during 2011 to 2019 were enrolled. Trend analysis was performed to evaluate differences in categories of diagnosis throughout study period, duration of PCCS, patient outcomes, DNR declaration, awareness of disease by patients and families before and after PCCS.ResultsIn total, 536 non-cancer patients received PCCS from 2011 to 2019 with an average age of 70.7 years. The average duration of PCCS was 18.4 days. The distributions of age, gender, patient outcomes, family’s awareness of disease before PCCS, and patient’s awareness of disease after PCCS were significantly different among the diagnoses. Organic brain disease and Chronic kidney disease (CKD) were the most prevalent diagnoses in patients receiving PCCS in 2019. For DNR declaration, the percentage of patients signing DNR before PCCS remained high throughout the study period (92.8% in 2019). Patient outcomes varied according to the disease diagnoses.ConclusionThis 9-year observational study showed that the trend of PCCS among non-cancer patients had changed over the duration of the study. An increasing number of terminally ill non-cancer patients received PCCS during late life, thereby increasing the awareness of disease for both patients and families, which would tend to better prepare terminally ill patients for end-of-life as they may consider DNR consent. Early integration of PCCS into ordinary care for terminally non-cancer patients is essential for better quality of life.

【 授权许可】

CC BY