Phase of Illness at the time of being referred to the hospital palliative care team and changes after the intervention

Abstract

Objective

Palliative care is provided according to patient needs. Healthcare providers can use the Phase of Illness to assess patient needs and improve palliative care. However, patients’ phase changes after the palliative care team’s intervention remain unknown.

Methods

This study clarified the Phase of Illness of patients referred to palliative care teams at hospitals and the changes in their phase after the intervention. Our study was a secondary analysis of a multicenter survey involving patient-reported outcomes. This study was conducted between February and August 2021 at eight facilities with palliative care teams. The participants were patients for whom the palliative care team received a new request for intervention during the patient enrollment period.

Results

Out of the 310 patients, 68 (21.9%) were in the stable phase, 141 (45.5%) in the unstable phase, 87 (28.1%) in the deteriorating phase, and 14 (4.5%) in the terminal phase at the time of referral. The total score for symptom distress at the time of referral was the highest in the deteriorating phase (65.7), followed by the unstable (54.1), terminal (47.5), and stable phases (40.5). Furthermore, 20.4% of patients in the unstable phase at the time of referral moved to the stable phase after one week of the intervention.

Conclusion

This study identified the distribution and changes in the Phase of Illness of patients referred to palliative care teams. Assessments for the Phase of Illness must be standardized in palliative care teams to set benchmarks.

Keywords:

• Palliative care
• Phase of Illness
• Palliative care team
• Treatment outcomes
• Prospective observational study

Acknowledgments

We pray for the repose of the soul of the late Dr. Masashi Kato, who chaired the Specialized Palliative Care Promotion Committee of the Japanese Society of Palliative Medicine when this study was initiated.

Disclaimer statements

Author contributions All authors contributed to the critical revision of the manuscript. Hironori Ohinata performed statistical analyses and drafted the manuscript. Eriko Satomi, Yoshiyuki Kizawa, Mayuko Miyazaki, Keita Tagami, Ryuichi Sekine, Kozue Suzuki, Nobuyuki Yotani, and Koji Sugeno collected the data, and Hideyuki Hirayama managed the data. Hironori Ohinata, Hideyuki Hirayama, Hirofumi Abo, Meidai Sakashita, Kazuki Sato, Sari Nakagawa, Yoko Nakazawa, Jun Hamano, and Mitsunori Miyashita contributed to the conception and design of the study. All authors have read and approved the final version of the manuscript.

Conflict of interest Eriko Satomi has accepted speaking fees from Terumo Corporation, Tsumura Corporation, Daiichisankyo Corporation, Pfizer Corporation, Hisamitsu Corporation and Shionogi & Co. Other authors have no conflict of interest to disclose.

Data management and sharing Data from this study are not available to the public following the study's ethical approval.

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/09699260.2024.2309788.

Additional information

Funding

This work was supported by the Japanese Society of Palliative Medicine; the Doctoral Program for World-Leading Innovative & Smart Education: Advanced Graduate Program for Future Medicine and Health Care, Tohoku University by the Ministry of Education, Culture, Sports, Science and Technology and the Japan Society for the Promotion of Science; and the Support for Pioneering Research Initiated by the Next Generation program by the Japan Science and Technology Agency [grant no JPMJSP2114].