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Supportive Care in Cancer

, Volume 26, Issue 5, pp 1393–1399 | Cite as

The impact of palliative care training for oncologists and integrative palliative service in a public-funded hospital cluster—a retrospective cohort study

  • Pak-Lun Lam
  • Tai-Chung Lam
  • Cheuk-Wai Choi
  • Anne Wing-Mui Lee
  • Kwok-Keung Yuen
  • To-Wai Leung
Original Article

Abstract

Purpose

Oncological care of advanced cancer patients was provided by multiple departments in Hong Kong. One of these departments, the clinical oncology department (COD), introduced systematic palliative care training for its oncologists since 2002. The COD was recognized as a European Society for Medical Oncology (ESMO) Designated Centre of Integrated Oncology and Palliative Care since 2009. This retrospective cohort study aims to review the impact of integrative training and service on palliative care coverage and outcome.

Methods

Clinical information, palliative service provision, and end-of-life outcomes of patients who passed away from lung, colorectal, liver, stomach, or breast cancer in the Hong Kong West public hospital network during July 2015 to December 2015 were collected.

Results

A total of 307 patients were analyzed. Around half (49.2%) were attended primarily by COD, and 68.9% received palliative service. There are significantly fewer patients referred to palliative care from other departments (p < 0.001), with only 19.9% of this patient group receiving palliative referral. COD patients had longer palliative coverage before death (median 65 days versus 24 days, p < 0.001), higher chance of receiving end-of-life care at hospice units (36.4 versus 21.2%, p = 0.003), lower ICU admission (0.66 versus 5.1%, p = 0.02), and higher percentage of receiving strong opioid in the last 30 days of life (51.0 versus 28.9%, p < 0.001) compared to other departments. In multivariable analysis, COD being the primary care team (odds ratio 12.2, p < 0.001) was associated with higher palliative care coverage.

Conclusion

The study results suggested that systematic palliative care training of oncologists and integrative palliative service model was associated with higher palliative service coverage and improved palliative care outcomes.

Keywords

Palliative care Oncology Patient outcome assessment Hong Kong 

Notes

Authorship

All authors made significant contributions to the conception, data acquisition, interpretation, analysis, initial draft, and final approval of this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study protocol was approved by the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (UW 17-043) on 9 February 2017. For this type of study, formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Pak-Lun Lam
    • 1
  • Tai-Chung Lam
    • 2
  • Cheuk-Wai Choi
    • 2
  • Anne Wing-Mui Lee
    • 2
  • Kwok-Keung Yuen
    • 3
  • To-Wai Leung
    • 3
  1. 1.Li Ka Shing Faculty of MedicineThe University of Hong KongPokfulamHong Kong
  2. 2.Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, Queen Mary HospitalThe University of Hong KongPokfulamHong Kong
  3. 3.Department of Clinical OncologyQueen Mary HospitalPokfulamHong Kong

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