Symptom burden of haematological malignancies as death approaches in a community palliative care service: A retrospective cohort study of a consecutive case series

LeBlanc, TWW; Smith, JM; Currow, DC

Symptom burden of haematological malignancies as death approaches in a community palliative care service: A retrospective cohort study of a consecutive case series

LeBlanc, TWW Smith, JM Currow, DC

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Publication Type:: Journal Article
Citation:: The Lancet Haematology, 2015, 2 (8), pp. e334 - e338
Issue Date:: 2015-01-01

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Field	Value	Language
dc.contributor.author	LeBlanc, TWW	en_US
dc.contributor.author	Smith, JM	en_US
dc.contributor.author	Currow, DC https://orcid.org/0000-0003-1988-1250	en_US
dc.date.available	2015-05-27	en_US
dc.date.issued	2015-01-01	en_US
dc.identifier.citation	The Lancet Haematology, 2015, 2 (8), pp. e334 - e338	en_US
dc.identifier.uri	http://hdl.handle.net/10453/119041
dc.description.abstract	© 2015 Elsevier Ltd. All rights reserved. BACKGROUND: Patients with haematological malignancies are less likely to use palliative care services than are patients with solid tumours. This difference might stem from differing symptom burden, care needs, disease trajectories, or a combination of these factors. We described symptom burden and physical decline over time for people with haematological malignancies compared with people with solid tumours in a consecutive case series. METHODS: We included patients admitted to Silver Chain Hospice Care Service who died between Jan 1, 2011, and Dec 31, 2013, and who completed the eight-item Symptom Assessment Scale (0-10, with 0=no distress and 10=worst distress) at each clinical encounter. Physical function was assessed with the Australia-modified Karnofsky performance scale. Symptom and functional assessments were analysed at 7 days, 30 days, 60 days, and 90 days before death, by descriptive statistics. FINDINGS: We included 4638 participants. For people with haematological malignancies (n=224), the most troublesome symptoms were fatigue (mean score 5·2, SD 2·7) and loss of appetite (2·3, SD 2·9), and both worsened significantly near death (p=0·0035 for fatigue, p=0·016 for appetite). Other symptoms were often absent, and changed little over time. Compared with patients with solid tumours (n=4414), there were no significant differences in individual or cumulative symptom scores, changes over time, or the pattern of functional decline. INTERPRETATION: Community patients with haematological malignancies receiving palliative care have similar symptoms and patterns of physical decline at the end of life to people with solid tumours, suggesting similar care needs. This finding questions present limited palliative care service use by patients with haematological malignancies. FUNDING: None.	en_US
dc.relation.ispartof	The Lancet Haematology	en_US
dc.relation.isbasedon	10.1016/S2352-3026(15)00111-8	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Hematologic Neoplasms	en_US
dc.subject.mesh	Palliative Care	en_US
dc.subject.mesh	Hospice Care	en_US
dc.subject.mesh	Retrospective Studies	en_US
dc.subject.mesh	Cost of Illness	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	Symptom burden of haematological malignancies as death approaches in a community palliative care service: A retrospective cohort study of a consecutive case series	en_US
dc.type	Journal Article
utslib.citation.volume	8	en_US
utslib.citation.volume	2	en_US
utslib.for	1110 Nursing	en_US
utslib.for	1102 Cardiorespiratory Medicine and Haematology	en_US
utslib.for	1103 Clinical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access
pubs.issue	8	en_US
pubs.publication-status	Published	en_US
pubs.volume	2	en_US

Abstract:

© 2015 Elsevier Ltd. All rights reserved. BACKGROUND: Patients with haematological malignancies are less likely to use palliative care services than are patients with solid tumours. This difference might stem from differing symptom burden, care needs, disease trajectories, or a combination of these factors. We described symptom burden and physical decline over time for people with haematological malignancies compared with people with solid tumours in a consecutive case series. METHODS: We included patients admitted to Silver Chain Hospice Care Service who died between Jan 1, 2011, and Dec 31, 2013, and who completed the eight-item Symptom Assessment Scale (0-10, with 0=no distress and 10=worst distress) at each clinical encounter. Physical function was assessed with the Australia-modified Karnofsky performance scale. Symptom and functional assessments were analysed at 7 days, 30 days, 60 days, and 90 days before death, by descriptive statistics. FINDINGS: We included 4638 participants. For people with haematological malignancies (n=224), the most troublesome symptoms were fatigue (mean score 5·2, SD 2·7) and loss of appetite (2·3, SD 2·9), and both worsened significantly near death (p=0·0035 for fatigue, p=0·016 for appetite). Other symptoms were often absent, and changed little over time. Compared with patients with solid tumours (n=4414), there were no significant differences in individual or cumulative symptom scores, changes over time, or the pattern of functional decline. INTERPRETATION: Community patients with haematological malignancies receiving palliative care have similar symptoms and patterns of physical decline at the end of life to people with solid tumours, suggesting similar care needs. This finding questions present limited palliative care service use by patients with haematological malignancies. FUNDING: None.

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http://hdl.handle.net/10453/119041