COVID-19 and End of Life in a Quaternary Australian Hospital: Referral for Palliative Care Consultation
Background: The coronavirus disease 2019 (COVID-19) pandemic resulted in complex physical and psychosocial symptom burden at end of life. The benefit of specialist palliative care input in other disease states has been established, however, there is little evidence on referral patterns to these serv...
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| Format: | Article |
| Language: | English |
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Mary Ann Liebert
2024-01-01
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| Series: | Palliative Medicine Reports |
| Subjects: | |
| Online Access: | https://www.liebertpub.com/doi/full/10.1089/PMR.2023.0069 |
| _version_ | 1797346094898741248 |
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| author | Chelsea Patterson Linda Foreman |
| author_facet | Chelsea Patterson Linda Foreman |
| author_sort | Chelsea Patterson |
| collection | DOAJ |
| description | Background: The coronavirus disease 2019 (COVID-19) pandemic resulted in complex physical and psychosocial symptom burden at end of life. The benefit of specialist palliative care input in other disease states has been established, however, there is little evidence on referral patterns to these services in patients dying from COVID-19.
Objectives: This retrospective audit investigated the referral patterns for patients who died from COVID-19 at a quaternary hospital in South Australia (the Royal Adelaide Hospital) over a six-month period in 2022, and whether demographic features or COVID-19 specific factors had an impact on whether these patients received specialist palliative care services (PCS). The second aim was to identify prescription patterns for patients in the last 24 hours of life, and whether this was impacted by referral.
Method: Data were obtained from electronic medical records and analyzed using binary logistic regressions for referral to PCS versus no referral based on various predictors.
Results: There was no significant difference comparing patient demographics or COVID-19 specific factors with referral to PCS. There was statistical significance between patients who received referral to PCS and those who had a higher oral morphine equivalent daily dose (OMEDD) in the 24 hours before death, as well as the presence of a continuous subcutaneous infusion. Although the cause of this relationship is undetermined, it may represent the prescription patterns of the palliative care physicians during consultation or potentially higher symptom burden prompting referral. There was also a higher proportion of patients who received hydromorphone compared with other opioids, though the OMEDD was consistent with other published literature. |
| first_indexed | 2024-03-08T11:26:49Z |
| format | Article |
| id | doaj.art-71de91cf37544a2e8daed940122862b4 |
| institution | Directory Open Access Journal |
| issn | 2689-2820 |
| language | English |
| last_indexed | 2024-03-08T11:26:49Z |
| publishDate | 2024-01-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Palliative Medicine Reports |
| spelling | doaj.art-71de91cf37544a2e8daed940122862b42024-01-26T05:11:03ZengMary Ann LiebertPalliative Medicine Reports2689-28202024-01-01513910.1089/PMR.2023.0069COVID-19 and End of Life in a Quaternary Australian Hospital: Referral for Palliative Care ConsultationChelsea PattersonLinda ForemanBackground: The coronavirus disease 2019 (COVID-19) pandemic resulted in complex physical and psychosocial symptom burden at end of life. The benefit of specialist palliative care input in other disease states has been established, however, there is little evidence on referral patterns to these services in patients dying from COVID-19. Objectives: This retrospective audit investigated the referral patterns for patients who died from COVID-19 at a quaternary hospital in South Australia (the Royal Adelaide Hospital) over a six-month period in 2022, and whether demographic features or COVID-19 specific factors had an impact on whether these patients received specialist palliative care services (PCS). The second aim was to identify prescription patterns for patients in the last 24 hours of life, and whether this was impacted by referral. Method: Data were obtained from electronic medical records and analyzed using binary logistic regressions for referral to PCS versus no referral based on various predictors. Results: There was no significant difference comparing patient demographics or COVID-19 specific factors with referral to PCS. There was statistical significance between patients who received referral to PCS and those who had a higher oral morphine equivalent daily dose (OMEDD) in the 24 hours before death, as well as the presence of a continuous subcutaneous infusion. Although the cause of this relationship is undetermined, it may represent the prescription patterns of the palliative care physicians during consultation or potentially higher symptom burden prompting referral. There was also a higher proportion of patients who received hydromorphone compared with other opioids, though the OMEDD was consistent with other published literature.https://www.liebertpub.com/doi/full/10.1089/PMR.2023.0069COVID-19palliative care consultationprescription patternsreferral |
| spellingShingle | Chelsea Patterson Linda Foreman COVID-19 and End of Life in a Quaternary Australian Hospital: Referral for Palliative Care Consultation Palliative Medicine Reports COVID-19 palliative care consultation prescription patterns referral |
| title | COVID-19 and End of Life in a Quaternary Australian Hospital: Referral for Palliative Care Consultation |
| title_full | COVID-19 and End of Life in a Quaternary Australian Hospital: Referral for Palliative Care Consultation |
| title_fullStr | COVID-19 and End of Life in a Quaternary Australian Hospital: Referral for Palliative Care Consultation |
| title_full_unstemmed | COVID-19 and End of Life in a Quaternary Australian Hospital: Referral for Palliative Care Consultation |
| title_short | COVID-19 and End of Life in a Quaternary Australian Hospital: Referral for Palliative Care Consultation |
| title_sort | covid 19 and end of life in a quaternary australian hospital referral for palliative care consultation |
| topic | COVID-19 palliative care consultation prescription patterns referral |
| url | https://www.liebertpub.com/doi/full/10.1089/PMR.2023.0069 |
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