Abstract:
BACKGROUND:Early involvement of palliative care and advance care planning improves quality of life outcomes and survival for patients with advanced lung cancer, however there are barriers to implementation. AIMS AND METHODS:A single-centre prospective audit reviewing "Goals of Care" (GOC) form completion and palliative care referrals in an oncology clinic was undertaken with the aim of increasing GOC completion and palliative care referrals for patients with advanced lung cancer. Involved physicians attended a communication skills course and then received a communication-priming interventions. Clinicopathological factors associated with GOC completion and palliative care referral were explored. RESULTS:84 patients receiving palliative treatment for advanced lung cancer were enrolled. Clinicopathological factors, such as poorer performance status were associated with higher likelihood of GOC completion (p = 0.018) prior to the intervention. Male sex (p = 0.023), absence of a sensitising EGFR mutation or ALK rearrangement (p = 0.017), type of systemic therapy (p = 0.031) and poorer performance status (p < 0.001) were associated with higher likelihood of palliative care referral. The intervention improved GOC completion (RR 1.29 p = 0.004), however this was not sustained in a follow-up audit (RR 0.98 p = 0.92) and there was no change in palliative care referral rate (RR 2.5, p = 0.16). Predictors of palliative referral following clinical review included age (RR 1.16, p = 0.001), male sex (RR 14.2, p = 0.02) and poorer performance status (RR 1.76, p < 0.001). CONCLUSION:Communication-priming interventions can improve GOC completion for patients with advanced lung cancer. Further investigation is needed to pursue sustainable options for managing this complex patient group and improve guideline-adherence and patient care. This article is protected by copyright. All rights reserved.
journal_name
Intern Med Jjournal_title
Internal medicine journalauthors
Conduit C,Thompson M,Thomas R,Nott L,Wuttke Mdoi
10.1111/imj.14817subject
Has Abstractpub_date
2020-03-23 00:00:00eissn
1444-0903issn
1445-5994pub_type
杂志文章abstract:BACKGROUND:The effects of empagliflozin on cardiac structure and function are not known. AIMS:To examine the changes in cardiac structure and function following the addition of empagliflozin in patients with type 2 (T2D) diabetes using cardiac magnetic resonance (CMR) imaging. METHODS:Twenty patients attending a spec...
journal_title:Internal medicine journal
pub_type: 杂志文章
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更新日期:2019-08-01 00:00:00
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journal_title:Internal medicine journal
pub_type: 杂志文章
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pub_type: 杂志文章,meta分析
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更新日期:2018-10-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,meta分析
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pub_type: 杂志文章
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更新日期:2021-01-20 00:00:00
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1111/imj.14994
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