Characteristics of patients referred and admited to palliative care services in Portugal in 2017 and the effectiveness of symptom management

Abstract

Introduction: To help identify issues and areas of improvement in the palliative healthcare system in Portugal, information on current conditions of services delivery and utilization must be obtained and analyzed. One way of accomplishing this is by characterizing patients who received palliative care services and measuring quality of care through effective symptom management. Methods: A descriptive and analytical epidemiological study was conducted on 376 patients from six palliative care teams/services that participated in the research project. A specific questionnaire was used to determine patients’ sociodemographic, clinical, admission and referral process characteristics. To measure effectiveness of symptom management, a validated FACIT-Pal tool was used. Scores were analyzed to determine significant changes or improvement. Results: Palliative care patients were mostly male (51.9%), 60 years and older (82.4%), married or in civil union (54.5%), had no or primary level educational background (86.1%) and were residing in Lisbon (43.9%) in a predominantly urban area (72.9%). Almost all patients had informal caregivers (97.1%). Majority of the patients had a cancer diagnosis (84.8%), 14.1%were noncancer and 1.1% with mixed diagnosis. The referral and admission process mostly took place within a month. Patients were usually referred from hospital units due to clinical issues – symptomatic control, need for palliative intervention, or pharmacological management. Half were cared for at home. The median survival period was 44 days. Using the FACIT-Pal tool it was revealed that there was a statistically significant difference in the Palliative Subscale and the Total Score (p=0.008 and p=0.035 respectively) seven days from the initial assessment suggesting effective symptom management. Conclusion: This study showed the characteristics of palliative care patients and the effectiveness of symptom management by the palliative care services/teams. These findings helped determine trends in palliative care needs and showed efficiency and quality of care from existing structures, as well as areas that would benefit from change or improvement.

Date of Award	30 Mar 2021
Original language	English
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Manuel Luís Capelas (Supervisor)