Patient perceptions of an outpatient palliative care intervention: "It had been on my mind before, but I did not know how to start talking about death..." |
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Authors: | Rabow Michael W Schanche Karen Petersen Jane Dibble Suzanne L McPhee Stephen J |
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Institution: | Division of General Internal Medicine, University of California at San Francisco, San Francisco, California 94115, USA. |
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Abstract: | Little is known about whether introducing palliative care to seriously ill outpatients continuing to pursue treatment of their disease is acceptable or beneficial to patients. Intervention patients in a trial of outpatient palliative care consultation completed structured exit interviews as part of a qualitative study. Participants had advanced heart or lung disease or cancer, and a life expectancy between 1 to 5 years as estimated by their primary care physician (PCP). Thirty-five of 50 intervention patients (70%) completed the final interview. Twenty-one patients (60%) reported that the team uncovered previously undiagnosed medical problems, 12 patients (34.3%) reported decreased primary care visits, and 8 (22.9%) reported avoiding emergency department visits. Most patients reported improved satisfaction with family caregivers (85.7%), PCPs (80%), and the medical center (65.7%). Most patients (68.6%) would have wanted the intervention even earlier in the course of their illness. Seriously ill outpatients found palliative care acceptable and helpful, reporting increased satisfaction and decreased health care utilization. |
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