Association of a pediatric palliative oncology clinic on palliative care access, timing and location of care for children with cancer

Title

Association of a pediatric palliative oncology clinic on palliative care access, timing and location of care for children with cancer

Creator

Brock K E; Allen K E; Falk E; Velozzi-Averhoff C; DeGroote N P; Klick J; Wasilewski-Masker K

Publisher

Supportive Care in Cancer

Date

2020

Subject

Pediatric oncology; Pediatric palliative care; Supportive care; End-of-life

Description

BACKGROUND: Most pediatric palliative care (PPC) services are inpatient consultation services and do not reach patients and families in the outpatient and home settings, where a vast majority of oncology care occurs. We explored whether an embedded pediatric palliative oncology (PPO) clinic is associated with receipt and timing of PPC and hospital days in the last 90 days of life. METHODS: Oncology patients (ages 0-25) with a high-risk event (death, relapse/progression, and/or phase I/II clinical trial enrollment) between 07/01/2015 and 06/30/2018 were included. PPO clinic started July 2017. Two cohorts were defined: pre-PPO (high-risk event(s) occurring 07/01/2015-06/30/2017) and post-PPO (high-risk event(s) occurring 07/01/2017-06/30/2018). Descriptive statistics were performed; demographic, disease course, and outcomes variables across cohorts were compared. RESULTS: A total of 426 patients were included (pre-PPO n = 235; post-PPO n = 191). Forty-seven patients with events in both pre- and post-PPO cohorts were included in the post-PPO cohort. Mean age at diagnosis was 8 years. Diagnoses were evenly distributed among solid tumors, brain tumors, and leukemia/lymphoma. Post-PPO cohort patients received PPC more often (45.6% vs. 21.3%, p < 0.0001), for a longer time before death than the pre-PPO cohort (median 88 vs. 32 days, p = 0.027), and spent fewer days hospitalized in the last 90 days of life (median 3 vs. 8 days, p = 0.0084). CONCLUSION: A limited-day, embedded PPO clinic was associated with receipt of PPC and spending more time at home in patients with cancer who had high-risk events. Continued improvements to these outcomes would be expected with additional oncology provider education and PPO personnel.

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Citation List Month

Oncology 2020 List

Collection

Citation

Brock K E; Allen K E; Falk E; Velozzi-Averhoff C; DeGroote N P; Klick J; Wasilewski-Masker K, “Association of a pediatric palliative oncology clinic on palliative care access, timing and location of care for children with cancer,” Pediatric Palliative Care Library, accessed October 23, 2021, https://pedpalascnetlibrary.omeka.net/items/show/17361.

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