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Referral patterns of nonmalignant patients to an Irish specialist palliative medicine service: a retrospective review.
Am J Hosp Palliat Care. 2013 Jun; 30(4):399-402.AJ

Abstract

BACKGROUND

Our perception is that the proportion of referrals made to the specialist palliative medicine service (SPMS) in our institution for patients with a primary diagnosis of nonmalignant disease is high and that these patients are often referred late in their illness. We aimed to review the symptom burden and referral patterns of patients with a noncancer diagnosis to the SPMS in our centre.

METHODS

All new non-malignant referrals to the SPMS in 2009 were included. Data were collected from patients' medical records and analyzed using Excel.

RESULTS

Ninety-two referrals were identified: 60 (65%) female, 32 (35%) male. Mean age 76.5 years (21-92). Reasons for referral included: end-of-life care (n=55, 60%), symptom control (n=23, 25%), home care support (n=13, 14%) and psychological support (n=1, 1%). Mean time from admission to referral was 24.9 days (<1-165). Fifty-six (61%) patients were commenced on a syringe driver (CSCI), with a mean time spent on a CSCI of 2.8 days (< 1-17). Primary outcomes included: death (n=72, 78.5%), home discharge (n=9, 10%), discharge to another care institution (n=6, 6.5%), discharge from service (n=3, 3%) and hospice transfer (n=2, 2%). Mean time from referral to outcome was 4.6 days (<1-35).

CONCLUSION

The proportion of noncancer patients referred to the SPMS is our institution is high. This study confirms that nonmalignant referrals are commonly sent to the SPMS when patients are actively dying or very imminently dying. Further education of colleagues is warranted in the role of the SPMS, particularly with regard to earlier referral.

Authors+Show Affiliations

Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, Toronto, Canada. drelainewallace@gmail.comNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22811210

Citation

Wallace, Elaine M., and Eoin Tiernan. "Referral Patterns of Nonmalignant Patients to an Irish Specialist Palliative Medicine Service: a Retrospective Review." The American Journal of Hospice & Palliative Care, vol. 30, no. 4, 2013, pp. 399-402.
Wallace EM, Tiernan E. Referral patterns of nonmalignant patients to an Irish specialist palliative medicine service: a retrospective review. Am J Hosp Palliat Care. 2013;30(4):399-402.
Wallace, E. M., & Tiernan, E. (2013). Referral patterns of nonmalignant patients to an Irish specialist palliative medicine service: a retrospective review. The American Journal of Hospice & Palliative Care, 30(4), 399-402. https://doi.org/10.1177/1049909112453080
Wallace EM, Tiernan E. Referral Patterns of Nonmalignant Patients to an Irish Specialist Palliative Medicine Service: a Retrospective Review. Am J Hosp Palliat Care. 2013;30(4):399-402. PubMed PMID: 22811210.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Referral patterns of nonmalignant patients to an Irish specialist palliative medicine service: a retrospective review. AU - Wallace,Elaine M, AU - Tiernan,Eoin, Y1 - 2012/07/18/ PY - 2012/7/20/entrez PY - 2012/7/20/pubmed PY - 2013/10/18/medline KW - end-of-life KW - nonmalignant KW - palliative medicine KW - referral patterns KW - symptoms SP - 399 EP - 402 JF - The American journal of hospice & palliative care JO - Am J Hosp Palliat Care VL - 30 IS - 4 N2 - BACKGROUND: Our perception is that the proportion of referrals made to the specialist palliative medicine service (SPMS) in our institution for patients with a primary diagnosis of nonmalignant disease is high and that these patients are often referred late in their illness. We aimed to review the symptom burden and referral patterns of patients with a noncancer diagnosis to the SPMS in our centre. METHODS: All new non-malignant referrals to the SPMS in 2009 were included. Data were collected from patients' medical records and analyzed using Excel. RESULTS: Ninety-two referrals were identified: 60 (65%) female, 32 (35%) male. Mean age 76.5 years (21-92). Reasons for referral included: end-of-life care (n=55, 60%), symptom control (n=23, 25%), home care support (n=13, 14%) and psychological support (n=1, 1%). Mean time from admission to referral was 24.9 days (<1-165). Fifty-six (61%) patients were commenced on a syringe driver (CSCI), with a mean time spent on a CSCI of 2.8 days (< 1-17). Primary outcomes included: death (n=72, 78.5%), home discharge (n=9, 10%), discharge to another care institution (n=6, 6.5%), discharge from service (n=3, 3%) and hospice transfer (n=2, 2%). Mean time from referral to outcome was 4.6 days (<1-35). CONCLUSION: The proportion of noncancer patients referred to the SPMS is our institution is high. This study confirms that nonmalignant referrals are commonly sent to the SPMS when patients are actively dying or very imminently dying. Further education of colleagues is warranted in the role of the SPMS, particularly with regard to earlier referral. SN - 1938-2715 UR - https://www.unboundmedicine.com/medline/citation/22811210/Referral_patterns_of_nonmalignant_patients_to_an_Irish_specialist_palliative_medicine_service:_a_retrospective_review_ L2 - https://journals.sagepub.com/doi/10.1177/1049909112453080?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -