Prevalence of Pain and Effectiveness of Home-based Palliative Care in Patients with Advanced Cancer: Primary care of Saraburi hospital, Descriptive study
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Abstract
Objective: To evaluate the prevalence of pain and effectiveness of home-based palliative care in patients with advanced cancer in the Primary Care Cluster, Saraburi Hospital
Design: The study was a descriptive study of 79 palliative cancer cases who were sent to the Primary Care Cluster, Saraburi Hospital, from July to November 2020.
Materials and Methods: Home visit interviews were conducted. Patient characteristics, symptoms, and symptom managements on the 1st and the 14th day of home visits, drug categories and advanced care plans were measured by the interviews. The prevalence of pain was described by the percentage. The outcomes of home-based palliative care were described by the percentage mean ± SD. The paired t-test was used for analyses of the mean symptoms score on the 1st and the 14th day after a home visit.
Results: The prevalence of pain was 74.68% and 64.56% of these patients had moderate-to-severe pain. The outcome of home-based palliative care showed a significant reduction of the mean pain score on the 1st and the 14th day after the home visit (4.65 ± 3.40 and 2.45 ± 1.90, p < 0.001). Moreover, patients who had completed a living will in an advanced care plan were 69.74%. Finally, the patient visits to the Emergency Department were 37.90% and patient hospitalizations were 34.17%.
Conclusion: The majority of advanced cancers cause a lot of pain. More than half of patients have moderate-to-severe pain. Therefore, home-based palliative care can alleviate the patients’ uncontrolled symptoms, increase accessibility of holistic care, improve quality and comprehensive care, and achieve an advanced care plan. In summary, home-based palliative care should be recommended for family physicians in primary care.
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