Cedars-Sinai Medical Center, Los Angeles, CA
Eve Makoff, Arvind Manohar Shinde, Richard Tuli, Andrew Eugene Hendifar
Background: Pancreatic adenocarcinoma is the 4th leading cause of cancer death in the US. It is predicted to become the 2nd leading cause by 2030. Advanced disease at diagnosis is common. Fewer than 20% of patients having long-term disease control. Given the high prevalence of physical and psychosocial needs, a quality initiative that embedded a PC physician in a pancreatic cancer program was initiated. Methods: From June 2015-October 2015, all stage III/IV pancreatic adenocarcinoma patients were referred for palliative consultation. * The PC physician was introduced as a supportive care medicine provider; a part of the comprehensive pancreas cancer program. *Other resources (ie RN, SW, Chaplain, RD) deployed as indicated *Patients seen initially and at least every 2 months * ESAS, PHQ2, and spiritual screens performed regularly * Data collected regarding symptom trajectory, resource utilization; and timing/place of death. Results: N=17. Conclusions: PSP demonstrated the ability of a PC provider to be effectively accepted and integrated into a pancreas program. Results suggest a benefit in the standardization of symptom screening/ intervention, and a possible favorable impact on healthcare resource utilization. Outcomes will continue to be tracked and compared with patients in the larger cancer community. Further study is indicated to assess the scalability and impact of this model of integrated care.
Data | N (%) |
---|---|
Median age | 65 |
Sex Male Female | 10 (58) 7 (42) |
Avg. # of visits | 4 |
Status: | |
Expired | 4 |
Non-ICU inpt | 1 |
Hospice | 3 |
Hospice | 2 |
Surgery | 1 |
Imminent surgery | 1 |
On treatment | 9 |
% PHQ2/Spiritual screen completed | 76 |
% ESAS Completed | 82 |
Initial visit mod-severe symptoms (>/= 4 on ESAS) | (%) |
Appetite | 52 |
Fatigue | 47 |
Wellbeing/pain | 41 |
Sleep/depression/nausea | 29 |
Drowsy/sob | 23 |
Subsequent visit scores were < 4 (mild) for sleep, depression, nausea, drowsy and sob. | |
The following were 4-4.8 (mod): | |
Appetite | 50 |
Fatigue | 50 |
Wellbeing/pain | 50 |
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