Hospital specialist palliative care team influence on end-of-life care in Coronavirus disease 2019? A retrospective observational cohort study

Duffy, T., Seaton, R. A., Mckeown, A., Keeley, P. , Sanzone, N., Quate, L., Farmer, E. and Stubbs, H. (2022) Hospital specialist palliative care team influence on end-of-life care in Coronavirus disease 2019? A retrospective observational cohort study. Palliative Medicine Reports, 3(1), pp. 235-243. (doi: 10.1089/pmr.2022.0041) (PMID:36341471) (PMCID:PMC9629908)

Abstract

Objectives: The coronavirus 19 disease (COVID-19) pandemic has led to a renewed focus on end-of-life care. The majority of COVID-19 deaths occur in hospital, with patients cared for by generalists and hospital specialist pal- liative care teams (HSPCTs). This project aims at exploring the potential influences of HSPCTs on end-of-life care in COVID-19. Methods: A retrospective observational study was carried out by exploring four end-of-life care themes in a Scot- tish hospital population who died from COVID-19. Comparison was made between cohorts seen by HSPCTs ver- sus generalist clinicians. Results: Analysis of 119 patients across NHS Greater Glasgow and Clyde (NHSGGC) health board demonstrated that COVID-19 patients seen by HSPCTs were more likely to be younger (median 77 vs. 81 years; p = 0.02), have a cancer diagnosis (21.7% vs. 5.4%; p = 0.01), die sooner after admission (median four vs. six days; p < 0.01), and be commenced on a syringe driver (89.1% vs. 42.5%; p < 0.01). Differences detected across four end-of-life care themes comparing HSPCTs with generalist teams were minimal with documentation and prescribing in keeping with available guidance. Conclusion: Consistencies in end-of-life care observed across NHSGGC cohorts draw attention to the potential wider impact of HSPCT roles, including education, guideline development, and mentoring. Understanding such diverse effects is important to support funding and development of HSPCTs. Further research is required to bet- ter quantify the impact and heterogenous influences of HSPCTs in general.

• Item Type: Articles
• Keywords: COVID-19, hospital care, terminal care.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: quate, Dr leza and Stubbs, Harrison and Keeley, Dr Paul and Mckeown, Dr Alistair
• Authors: Duffy, T., Seaton, R. A., Mckeown, A., Keeley, P., Sanzone, N., Quate, L., Farmer, E., and Stubbs, H.
• College/School: College of Medical Veterinary and Life Sciences; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Research Centre: College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Immunobiology
• Journal Name: Palliative Medicine Reports
• Publisher: Mary Ann Liebert
• ISSN: 2689-2820
• ISSN (Online): 2689-2820
• Published Online: 21 October 2022
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Palliative Medicine Reports 3(1):235-43.
• Publisher Policy: Reproduced under a Creative Commons License