Characteristics and care pathways of advanced cancer patients in a palliative-supportive care unit and an oncological ward.

Abstract BACKGROUND: A supportive palliative care unit (SPCU) may have a positive impact on patients' care. The aim of this study was to compare the pattern of patients admitted to a specialized SPCU and to a traditional oncologic ward (OW) in a consecutive sample of advanced cancer patients. METHODS: Data on patients demographics, reasons for and kind of admission, care-giver, anticancer treatments, being on/off treatment or uncertain, origin setting, who proposed hospital admission, the use of opioids, and hospitalization were gathered. The same parameters were recorded at discharge. A follow-up was performed by phone 1 month after discharge. RESULTS: Two-hundred patients were surveyed. Awareness of disease was more complete in OW patients (P\u2009=\u20090.001). Uncontrolled pain and symptoms were the prevalent reasons for admission to SPCU (P\u2009<\u20090.0005). Toxicity from chemotherapy was more frequently reported by OW patients (P\u2009=\u20090.001). SPCU patients received higher doses of opioids (P\u2009=\u20090.004). More SPCU patients were referred from home and were discharged home (P\u2009<\u20090.0005 and P\u2009=\u20090.018, respectively). Emergency admissions were more frequently reported in OW patients (P\u2009<\u20090.0005). One month after, more SPCU patients were at home and were still on active treatment (P\u2009=\u20090.002, and P\u2009=\u20090.05, respectively). More OW patients died within 1 month (P\u2009=\u20090.001). CONCLUSION: SPCU allows a better planning admission to hospital and a better care trajectory in advanced cancer patients in comparison to a busy OW, where unselected emergencies more frequently occur