The Outcome of Palliative Care Provision by Family Physicians at Chomthong Hospitall
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Abstract
Background: Chomthong Hospital is developing a palliative care system through Family Medicine physicians. However, the results have not yet been evaluated. Therefore, the researcher is interested in studying this issue to develop a better palliative care system.
Objective: To compare the palliative care outcomes between the two groups of patients treated by Family Medicine physicians and non-family physicians.
Methods: A retrospective cohort study on palliative care outcomes observed the patients who were hospitalized at Chomthong Hospital from June 1, 2020, to May 31, 2021. A total of 284 patients were collected from medical records. Baseline data were analyzed using frequency, percentage, and standard deviation, and compared the outcomes of patients between the two groups of physicians were with the chi-square test and independent t-test.
Result: A total of 169 (60%) palliative patients treated by Family Medicine physicians resulted in a greater end-of-life supportive outcomes from those of non-family physicians. The following results were observed: family meetings 80% (p < 0.001), an advanced care plan 91% (p < 0.001), no intubation 99% (p < 0.001), pain control received such as morphine or fentanyl 60% (p < 0.001), community referral and home visit received 70% (p < 0.001), did not return for treatment 99% (p = 0.010), hospitalization prevented 99% (p = 0.157), mean service satisfaction was 47 (SD 2.66) points (p < 0.001).
Conclusion: life processes and outcomes of care than non-family physicians. Therefore, the systematic development of palliative Palliative patients treated by Family Medicine physicians are more likely to have more supportive end-of- care along with the knowledge support for physicians in other fields to have a better understanding of palliative care will help improve the treatment results.
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References
กลุ่มข้อมูลข่าวสารสุขภาพ. สถิติสาธารณสุข พ.ศ. 2562. นนทบุรี: กองยุทธศาสตร์และแผนงาน กระทรวงสาธารณสุข; 2562
Cardona-Morrell M, Kim J, Turner RM, Anstey M, Mitchell IA, Hillman K. Non-beneficial treatments in hospital at the end of life: a systematic review on extent of the problem. Int J Qual Health Care. 2016;28(4):456-69.
World Health Organization. Palliative care [Internet]. 2020 [cited 11 february 2022]. Available from: https://www.who.int/news-room/fact-sheets/detail/palliative-care
National Comprehensive Cancer Network. NCCN Guidelines for supportive care:
palliative care [internet]. 2018 [cited 10 Jan 2022]. Available from : https://www.nccn. org/professionals/physician_gls/default.aspx#supportive.
Chiang JK, Kao YH. Quality of end-of-life care of home-based care with or without palliative services for patients with advanced illnesses. Medicine (Baltimore). 2021;100(18):1-7.
Cassel B. GM, May P.,Del fabbro E., Noreika D. Impact of specialist palliative care on re-admission: A " competing risk" analysis to take mortality into account Journal of Pain and Symptom Managemet 2018;55(2):581.
Hua M, Lu Y, Ma X, Morrison RS, Li G, Wunsch H. Association Between the Implementation of Hospital-Based Palliative Care and Use of Intensive Care During Terminal Hospitalizations. JAMA 2020;3(1):e1918675.
Elnadry J. Home-Based Palliative Care Reduces Hospital Reamissions Journal of Pain and Symptom Managemet. 2017;53(2):428 - 9.
Hughes MT, Smith TJ. The growth of palliative care in the United States. Annu Rev Public Health. 2014;35:459-75.
Wayne W. Daniel CLC. Biostatistics: A foundation for anlysis in the health sciences 10th ed. United States of America; 2013
Chetta Ngamjarus VC, Edward McNeil. n4Studies: Sample Size Calculation for an Epidemiological Study on a Smart Device. Siriraj Med J. 2016;68:160-70.
Neesanun S. Non-Beneficial Treatments in Hospitalized Advance Stage Cancer Patients. Region 3 Medical and Public Health Journal 2019;16:1-10
Brighton LJ, Bristowe K. Communication in palliative care: talking about the end of life, before the end of life. Postgrad Med J. 2016;92(1090):466-70.
ราชวิทยาลัยแพทย์เวชศาสตร์ครอบครัวแห่งประเทศไทย. หลักสูตรและเกณฑ์การฝึกอบรมแพทย์ประจำบ้าน เพื่อวุฒิบัตรแสดงความรู้ ความชำนาญ ในการประกอบวิชาชีพเวชกรรม สาขาเวชศาสตร์ครอบครัว 2561 [อินเทอร์เน็ต]. 2561 [เข้าถึงเมื่อ 11 ก.พ. 2565] เข้าถึงได้จาก: https://thaifammed.org/training/page-05
Karen Hancock JMC, Sharon M Parker,Phyllis N Butow, Sue Carrick,David Currow, et al. Truth-telling in discussing prognosis in advanced life-limiting illnesses: a systematic review. Palliative Medicine. 2007;21:507–17.
Bradley NM, Sinclair E, Danjoux C, et al. The do-not-resuscitate order: incidence of documentation in the medical records of cancer patients referred for palliative radiotherapy. Curr Oncol. 2006;13(2):47-54
Piili RP, Lehto JT, Luukkaala T, Hinkka H, Kellokumpu-Lehtinen PI. Does special education in palliative medicine make a difference in end-of-life decision-making. BMC Palliat Care. 2018;17(1):94.
ปฐมพร ศิรประภาศิริ,บรรณาธิการ. คู่มือการดูแลผู้ป่วยแบบประคับประคองและระยะท้าย (สำหรับบุคลากรทางการแพทย์). นนทบุรี:กรมการแพทย์ กระทรวงสาธารณสุข; 2563.
Abdi D. Osman MAR, Louisa Lam, Chien Che Lin, Michael Yeoh, Simon Judkins, Neely Pratten. Cardiopulmonary resuscitation and endotracheal intubation decisions for adults with advance care direction and resuscitation plans in the emergency department. Australasian Emergency Caer 2020;23(4):247 - 51.
สำนักงานปลัดกระทรวงสาธารณสุข. แนวทางการดำเนินงาน คลินิกหมอครอบครัว สำหรับหน่วยบริการ.นนทบุรี: สำนักบริหารการสาธารณสุข สำนักงานปลัดกระทรวงสาธารณสุข; 2559
Catherine Hudon M-CC, Fatoumata Diadion, Mireille Lambert. Danielle Bouliane. Case Management in Palliative Care for Frequent Users of health Care Services With Chronic Diseases: A Qualitation Study of Patient and Family Experience Ann Fam Med. 2015(13):523 -8.
Detsyk OZ BO, Babich PM. Quality of life of patients receiving home-based palliative care from family physicians and mobile palliative care team. Wiad Lek. 2020(73(8)):1681-9.
Dzierzanowski T, Kozlowski M. Opioid prescribing attitudes of palliative care physicians versus other specialists: a questionnaire-based survey. Postgrad Med J. 2022;98(1156):119-23.
Shofield G. Palliative opioid use, palliative sedation and euthanasia: reaffirming the distinction. J Med Ehtics. January 2020;46(1):48 - 50.
Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain--United States, 2016. JAMA. 2016;315(15):1624-45.
Lau J, Mazzotta P, Whelan C, et al. Opioid safety recommendations in adult palliative medicine: a North American Delphi expert consensus. BMJ Support Palliat Care. 2022;12(1):81-90.
Preuss CV, Kalava A, King KC. Prescription of Controlled Substances: Benefits and Risks. In: StatPearls. Treasure Island (FL): StatPearls Publishing; March 13, 2022.
Colleen Webber RV, Christine Knott, Yingwei Peng and Patti A. Groome. Community Palliative Care Initiatives to Reduce End- of-life Hospital Utilization and In-Hospital Deaths: A Population-Based Observation Study Evaluation Two Home Care Intervations. Journal of Pain and Symptom Managemet. 2019;58 (2):181 - 9.
Reyniers T, Houttekier D, Pasman HR, Stichele RV, Cohen J, Deliens L. The family physician's perceived role in preventing and guiding hospital admissions at the end of life: a focus group study. Ann Fam Med. 2014;12(5):441-6.
Radka Bužgová RK, Michal Bar Satisfaction of Patients With Severe Multiple Sclerosis and Their Family Members With Palliative Care: Interventional Study. American Journal of Hospice and Palliative Medicine2021;38(11):1348-55.
