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Patients attended by palliative care teams: are they always comparable populations? To answer this question we
have compared the basic epidemiological characteristics of patients attended by home palliative care teams (HPCT)
in two autonomous regions of Spain.
We carried out a coordinated analytical, observational and prospective study in two Spanish autonomous regions:
Aragon and Catalonia. Data were kept during each home care visit according to patients' needs. Inclusion criteria
were: advanced cancer, over 18 years old and first contact with a HPCT. The recruitment period was 6 months.
Variables included were: Survival time (days), age, sex, primary disease and extension, place of residence. Functional
and cognitive state, and co-morbidity. 10 signs/symptoms: asthenia, anorexia, cachexia, dysphagia, xerostomy,
dyspnoea, oedemas, level of consciousness, presence of delirium, presence of pressure ulcers and some treatment
data. Others variables considered were: responsible team, origin, destination when discharge, date and place of
death, number of visits made and duration of monitoring. We developed a comparison between groups by Chisquared
test or the non-parametric Mann–Whitney U test and a survival analysis by Kaplan-Meier curves and the
logrank test to determine differences between factors. The SPSS version 15.0 software package was used.
698 patients were included, 56.2% from Aragon and 43.8% from Catalonia. 60.3% were males, without differences
between the regions. Characteristics relative to age, sex, place of residence and extension of oncological diseases
were similar for both groups. We found significant differences between the two populations relative to survival
time, co-morbidity, functional state, presence and intensity of a number of symptoms and the treatments, patient
monitoring and the their destination after discharge.
We can conclude that palliative care teams cover different profiles of patients with regard to their co-morbidity,
functional, cognitive and symptomatic states. It must be pointed that the organization of palliative care services
and their experience appears to condition the profile of patients they attend. There is a need of consensus on the
basic descriptors for palliative care patients in order to ensure that results will be comparable. |
