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Supportive Care in Cancer

, Volume 26, Issue 6, pp 1961–1966 | Cite as

Characteristics and care pathways of advanced cancer patients in a palliative-supportive care unit and an oncological ward

  • Sebastiano MercadanteEmail author
  • Paolo Marchetti
  • Claudio Adile
  • Amanda Caruselli
  • Patrizia Ferrera
  • Andrea Costanzi
  • Alessandra Casuccio
Original Article

Abstract

Background

A supportive palliative care unit (SPCU) may have a positive impact on patients’ care. The aim of this study was to compare the pattern of patients admitted to a specialized SPCU and to a traditional oncologic ward (OW) in a consecutive sample of advanced cancer patients.

Methods

Data on patients demographics, reasons for and kind of admission, care-giver, anticancer treatments, being on/off treatment or uncertain, origin setting, who proposed hospital admission, the use of opioids, and hospitalization were gathered. The same parameters were recorded at discharge. A follow-up was performed by phone 1 month after discharge.

Results

Two-hundred patients were surveyed. Awareness of disease was more complete in OW patients (P = 0.001). Uncontrolled pain and symptoms were the prevalent reasons for admission to SPCU (P < 0.0005). Toxicity from chemotherapy was more frequently reported by OW patients (P = 0.001). SPCU patients received higher doses of opioids (P = 0.004). More SPCU patients were referred from home and were discharged home (P < 0.0005 and P = 0.018, respectively). Emergency admissions were more frequently reported in OW patients (P < 0.0005). One month after, more SPCU patients were at home and were still on active treatment (P = 0.002, and P = 0.05, respectively). More OW patients died within 1 month (P = 0.001).

Conclusion

SPCU allows a better planning admission to hospital and a better care trajectory in advanced cancer patients in comparison to a busy OW, where unselected emergencies more frequently occur.

Keywords

Supportive care Palliative care Advanced cancer patients Hospital admission Emergency 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Sebastiano Mercadante
    • 1
    Email author
  • Paolo Marchetti
    • 2
  • Claudio Adile
    • 1
  • Amanda Caruselli
    • 3
  • Patrizia Ferrera
    • 1
  • Andrea Costanzi
    • 2
  • Alessandra Casuccio
    • 4
  1. 1.Anesthesia and Intensive Care Unit and Pain Relief and Supportive-Palliative Care UnitLa Maddalena Cancer CenterPalermoItaly
  2. 2.Department of Oncology, Hospital Sant’AndreaUniversity of RomeRomeItaly
  3. 3.Regional Palliative Care program, SAMOPalermoItaly
  4. 4.Department of Sciences for Health Promotion and Mother Child careUniversity of PalermoPalermoItaly

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