Specialist palliative and end-of-life care for patients with cancer and SARS-CoV-2 infection: a European perspective
Van Hemelrijck, M
AffiliationUniversity College London Hospitals; UKUCL Cancer Institute; Imperial College London; Hammersmith Hospital; Barts Health NHS Trust; Cardiff University; Velindre Cancer Centre; King’s College London; Vall d'Hebron University Hospital and Institute of Oncology; Chelsea & Westminster Hospital; Hospitalet de Llobregat; University Hospital Josep Trueta; Guy’s and St Thomas’ NHS Foundation Trust; Catalan Institute of Oncology; Hospital Clinic, Barcelona; University Hospital Munich; Universitat de Barcelona; Université Libre de Bruxelles; University of Piemonte Orientale and Maggiore della Carità Hospital; University of Eastern Piedmont; University of Chester
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AbstractBackground: Specialist palliative care team (SPCT) involvement has been shown to improve symptom control and end-of-life care for patients with cancer, but little is known as to how these have been impacted by the COVID-19 pandemic. Here, we report SPCT involvement during the first wave of the pandemic and compare outcomes for patients with cancer who received and did not receive SPCT input from multiple European cancer centres. Methods: From the OnCovid repository (n=1,318), we analysed cancer patients aged ≥18 diagnosed with COVID-19 between 26th February and 22nd June 2020 who had complete specialist palliative care team (SPCT) data (SPCT+ referred; SPCT- not referred). Results: Of 555 eligible patients, 317 were male (57.1%), with a median age of 70 (IQR 20). At COVID-19 diagnosis, 44.7% were on anti-cancer therapy and 53.3% had >1 co-morbidity. 206 patients received SPCT input for symptom control (80.1%), psychological support (54.4%), and/or advance care planning (51%). SPCT+ patients had more DNACPR orders completed prior to (12.6% vs. 3.7%) and during admission (50% vs 22.1%, P<0.001), with more SPCT+ patients deemed suitable for treatment escalation (50% vs. 22.1%, P<0.001). SPCT involvement was associated with higher discharge rates from hospital for end-of-life care (9.7% vs. 0%, P<0.001). End-of-life anticipatory prescribing was higher in SPCT+ patients, with opioids (96.3% vs. 47.1%) and benzodiazepines (82.9% vs. 41.2%) being used frequently for symptom control. Conclusions: SPCT referral facilitated symptom control, emergency care and discharge planning, as well as high rates of referral for psychological support than previously reported. Our study highlighted the critical need of SPCT for patients with cancer during the pandemic and should inform service planning for this population.
CitationSoosaipillai, G., Wu, A., Dettorre, G. M., Diamantis, J., Chester, J., Moss, C., Aguilar-Company, J., Bower, M., Sng, C. C. T., Salazar, R., Brunet, J., Jones, E., Mesia, R., Jackson, A., Mukherjee, U., Sita-Lumsden, A., Seguí, E., Ottaviani, D., Carbó, ... Pinato, D. J. (2021). Specialist palliative and end-of-life care for patients with cancer and SARS-CoV-2 infection: A European perspective. Therapeutic Advances in Medical Oncology, https://doi.org/10.1177/17588359211042224
DescriptionSoosaipillai, G., Wu, A., Dettorre, G. M., Diamantis, J., Chester, J., Moss, C., Aguilar-Company, J., Bower, M., Sng, C. C. T., Salazar, R., Brunet, J., Jones, E., Mesia, R., Jackson, A., Mukherjee, U., Sita-Lumsden, A., Seguí, E., Ottaviani, D., Carbó, ... Pinato, D. J. Specialist palliative and end-of-life care for patients with cancer and SARS-CoV-2 infection: a European perspective, Therapeutic Advances in Medical Oncology (Journal Volume Number and Issue Number) pp. xx-xx. Copyright ©  (Copyright Holder). Reprinted by permission of SAGE Publications.
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