Supporting the Needs of Adolescents and Young Adults: Integrated Palliative Care and Psychiatry Clinic for Adolescents and Young Adults with Cancer
Clinical guidelines aimed at cancer care for adolescents and young adults (AYAs) encourage early integration of palliative care, yet there are scarce data to support these recommendations. We conducted a retrospective chart review of AYA patients, aged 15 to 39 years, who were referred to the Integr...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-02-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/4/770 |
| _version_ | 1797396780881543168 |
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| author | Mohamed Abdelaal Pamela J. Mosher Abha Gupta Breffni Hannon Christine Cameron Malka Berman Rahim Moineddin Jonathan Avery Laura Mitchell Madeline Li Camilla Zimmermann Ahmed al-Awamer |
| author_facet | Mohamed Abdelaal Pamela J. Mosher Abha Gupta Breffni Hannon Christine Cameron Malka Berman Rahim Moineddin Jonathan Avery Laura Mitchell Madeline Li Camilla Zimmermann Ahmed al-Awamer |
| author_sort | Mohamed Abdelaal |
| collection | DOAJ |
| description | Clinical guidelines aimed at cancer care for adolescents and young adults (AYAs) encourage early integration of palliative care, yet there are scarce data to support these recommendations. We conducted a retrospective chart review of AYA patients, aged 15 to 39 years, who were referred to the Integrated AYA Palliative Care and Psychiatry Clinic (IAPCPC) at the Princess Margaret Cancer Centre between May 2017 and November 2019 (<i>n</i> = 69). Demographic data, symptom prevalence, change in symptom scores between baseline consultation and first follow-up, and intensity of end-of-life care were collected from the patients’ medical charts, analyzed, and reported. Of the 69 patients, 59% were female, and sarcoma was the most common cancer. A majority of patients had at least one symptom scored as moderate to severe; tiredness, pain, and sleep problems were the highest scored symptoms. More than one-third used medical cannabis to manage their symptoms. Symptom scores improved in 61% after the first clinic visit. Out of the 69 patients, 50 (72.5%) had died by October 2020, with a median time between the initial clinic referral and death of 5 months (range 1–32). Three patients (6%) received chemotherapy, and eight (16%) were admitted to an intensive care unit during the last month of life. In conclusion, AYAs with advanced cancer have a high burden of palliative and psychosocial symptoms. Creating a specialized AYA palliative care clinic integrated with psychiatry showed promising results in improving symptom scores and end-of-life planning. |
| first_indexed | 2024-03-09T00:56:29Z |
| format | Article |
| id | doaj.art-5370e6bd61dc4306985fb0a6951802d4 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T00:56:29Z |
| publishDate | 2021-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-5370e6bd61dc4306985fb0a6951802d42023-12-11T16:52:30ZengMDPI AGCancers2072-66942021-02-0113477010.3390/cancers13040770Supporting the Needs of Adolescents and Young Adults: Integrated Palliative Care and Psychiatry Clinic for Adolescents and Young Adults with CancerMohamed Abdelaal0Pamela J. Mosher1Abha Gupta2Breffni Hannon3Christine Cameron4Malka Berman5Rahim Moineddin6Jonathan Avery7Laura Mitchell8Madeline Li9Camilla Zimmermann10Ahmed al-Awamer11Department of Supportive Care, University Health Network, Toronto, ON M5G 2C4, CanadaDepartment of Supportive Care, University Health Network, Toronto, ON M5G 2C4, CanadaPrincess Margaret Cancer Centre, University Health Network, 620 University Ave., Toronto, ON M5G 2C1, CanadaDepartment of Supportive Care, University Health Network, Toronto, ON M5G 2C4, CanadaPrincess Margaret Cancer Centre, University Health Network, 620 University Ave., Toronto, ON M5G 2C1, CanadaPrincess Margaret Cancer Centre, University Health Network, 620 University Ave., Toronto, ON M5G 2C1, CanadaDepartment of Family and Community Medicine, University of Toronto, 500 University Ave., Toronto, ON M5G 1V7, CanadaSchool of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, CanadaPrincess Margaret Cancer Centre, University Health Network, 620 University Ave., Toronto, ON M5G 2C1, CanadaDepartment of Supportive Care, University Health Network, Toronto, ON M5G 2C4, CanadaDepartment of Supportive Care, University Health Network, Toronto, ON M5G 2C4, CanadaDepartment of Supportive Care, University Health Network, Toronto, ON M5G 2C4, CanadaClinical guidelines aimed at cancer care for adolescents and young adults (AYAs) encourage early integration of palliative care, yet there are scarce data to support these recommendations. We conducted a retrospective chart review of AYA patients, aged 15 to 39 years, who were referred to the Integrated AYA Palliative Care and Psychiatry Clinic (IAPCPC) at the Princess Margaret Cancer Centre between May 2017 and November 2019 (<i>n</i> = 69). Demographic data, symptom prevalence, change in symptom scores between baseline consultation and first follow-up, and intensity of end-of-life care were collected from the patients’ medical charts, analyzed, and reported. Of the 69 patients, 59% were female, and sarcoma was the most common cancer. A majority of patients had at least one symptom scored as moderate to severe; tiredness, pain, and sleep problems were the highest scored symptoms. More than one-third used medical cannabis to manage their symptoms. Symptom scores improved in 61% after the first clinic visit. Out of the 69 patients, 50 (72.5%) had died by October 2020, with a median time between the initial clinic referral and death of 5 months (range 1–32). Three patients (6%) received chemotherapy, and eight (16%) were admitted to an intensive care unit during the last month of life. In conclusion, AYAs with advanced cancer have a high burden of palliative and psychosocial symptoms. Creating a specialized AYA palliative care clinic integrated with psychiatry showed promising results in improving symptom scores and end-of-life planning.https://www.mdpi.com/2072-6694/13/4/770adolescents and young adultspalliative caresymptom managementend of lifepsychosocialpsychiatry |
| spellingShingle | Mohamed Abdelaal Pamela J. Mosher Abha Gupta Breffni Hannon Christine Cameron Malka Berman Rahim Moineddin Jonathan Avery Laura Mitchell Madeline Li Camilla Zimmermann Ahmed al-Awamer Supporting the Needs of Adolescents and Young Adults: Integrated Palliative Care and Psychiatry Clinic for Adolescents and Young Adults with Cancer Cancers adolescents and young adults palliative care symptom management end of life psychosocial psychiatry |
| title | Supporting the Needs of Adolescents and Young Adults: Integrated Palliative Care and Psychiatry Clinic for Adolescents and Young Adults with Cancer |
| title_full | Supporting the Needs of Adolescents and Young Adults: Integrated Palliative Care and Psychiatry Clinic for Adolescents and Young Adults with Cancer |
| title_fullStr | Supporting the Needs of Adolescents and Young Adults: Integrated Palliative Care and Psychiatry Clinic for Adolescents and Young Adults with Cancer |
| title_full_unstemmed | Supporting the Needs of Adolescents and Young Adults: Integrated Palliative Care and Psychiatry Clinic for Adolescents and Young Adults with Cancer |
| title_short | Supporting the Needs of Adolescents and Young Adults: Integrated Palliative Care and Psychiatry Clinic for Adolescents and Young Adults with Cancer |
| title_sort | supporting the needs of adolescents and young adults integrated palliative care and psychiatry clinic for adolescents and young adults with cancer |
| topic | adolescents and young adults palliative care symptom management end of life psychosocial psychiatry |
| url | https://www.mdpi.com/2072-6694/13/4/770 |
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