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. 1999 Aug 10;161(3):290–293.

Edmonton Regional Palliative Care Program: impact on patterns of terminal cancer care

E Bruera 1, C M Neumann 1, B Gagnon 1, C Brenneis 1, P Kneisler 1, P Selmser 1, J Hanson 1
PMCID: PMC1230508  PMID: 10463053

Abstract

The Edmonton Regional Palliative Care Program was established in July 1995 to measure the access of patients with terminal cancer to palliative care services, decrease the number of cancer-related deaths in acute care facilities and increase the participation of family physicians in the care of terminally ill patients. In this retrospective study the authors compared the pattern of care and site of deaths before establishment of the program (1992/93) and during its second year of operation (1996/97). Significantly more cancer-related deaths occurred in acute care facilities in 1992/93 than in 1996/97 (86% [1119/1304] v. 49% [633/1279]) (p < or = 0.001). The number of inpatient days decreased, from 24,566 in 1992/93 to 6960 in 1996/97. More cancer patients saw a palliative care consult team in 1996/97 than in 1992/93 (82% v. 22%). The shift from deaths in acute care facilities to palliative hospices suggests that the establishment of an integrated palliative care program has increased access of patients with terminal cancer to palliative care.

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Selected References

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  1. Bruera E., Kuehn N., Miller M. J., Selmser P., Macmillan K. The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care. 1991 Summer;7(2):6–9. [PubMed] [Google Scholar]
  2. Bruera E., MacMillan K., Hanson J., MacDonald R. N. The Edmonton staging system for cancer pain: preliminary report. Pain. 1989 May;37(2):203–209. doi: 10.1016/0304-3959(89)90131-0. [DOI] [PubMed] [Google Scholar]
  3. Bruera E., Moyano J., Seifert L., Fainsinger R. L., Hanson J., Suarez-Almazor M. The frequency of alcoholism among patients with pain due to terminal cancer. J Pain Symptom Manage. 1995 Nov;10(8):599–603. doi: 10.1016/0885-3924(95)00084-4. [DOI] [PubMed] [Google Scholar]
  4. Bruera E., Navigante A., Barugel M., Macmillan K., MacDonald R. N., Chacon R. Treatment of pain and other symptoms in cancer patients: patterns in a North American and a South American hospital. J Pain Symptom Manage. 1990 Apr;5(2):78–82. doi: 10.1016/s0885-3924(05)80020-x. [DOI] [PubMed] [Google Scholar]
  5. Bruera E., Schoeller T., Wenk R., MacEachern T., Marcelino S., Hanson J., Suarez-Almazor M. A prospective multicenter assessment of the Edmonton staging system for cancer pain. J Pain Symptom Manage. 1995 Jul;10(5):348–355. doi: 10.1016/0885-3924(95)00052-z. [DOI] [PubMed] [Google Scholar]
  6. Cleeland C. S., Gonin R., Hatfield A. K., Edmonson J. H., Blum R. H., Stewart J. A., Pandya K. J. Pain and its treatment in outpatients with metastatic cancer. N Engl J Med. 1994 Mar 3;330(9):592–596. doi: 10.1056/NEJM199403033300902. [DOI] [PubMed] [Google Scholar]
  7. Conill C., Verger E., Henríquez I., Saiz N., Espier M., Lugo F., Garrigos A. Symptom prevalence in the last week of life. J Pain Symptom Manage. 1997 Dec;14(6):328–331. doi: 10.1016/s0885-3924(97)00263-7. [DOI] [PubMed] [Google Scholar]
  8. Coyle N., Adelhardt J., Foley K. M., Portenoy R. K. Character of terminal illness in the advanced cancer patient: pain and other symptoms during the last four weeks of life. J Pain Symptom Manage. 1990 Apr;5(2):83–93. doi: 10.1016/s0885-3924(05)80021-1. [DOI] [PubMed] [Google Scholar]
  9. Fainsinger R. L., Bruera E., MacMillan K. Innovative palliative care in Edmonton. Can Fam Physician. 1997 Nov;43:1983-6, 1989-92. [PMC free article] [PubMed] [Google Scholar]
  10. Fainsinger R., Miller M. J., Bruera E., Hanson J., Maceachern T. Symptom control during the last week of life on a palliative care unit. J Palliat Care. 1991 Spring;7(1):5–11. [PubMed] [Google Scholar]
  11. Folstein M. F., Fetting J. H., Lobo A., Niaz U., Capozzoli K. D. Cognitive assessment of cancer patients. Cancer. 1984 May 15;53(10 Suppl):2250–2257. doi: 10.1002/cncr.1984.53.s10.2250. [DOI] [PubMed] [Google Scholar]
  12. Higginson I., Webb D., Lessof L. Reducing hospital beds for patients with advanced cancer. Lancet. 1994 Aug 6;344(8919):409–409. doi: 10.1016/s0140-6736(94)91437-0. [DOI] [PubMed] [Google Scholar]
  13. Hunt R., Bonett A., Roder D. Trends in the terminal care of cancer patients: South Australia, 1981-1990. Aust N Z J Med. 1993 Jun;23(3):245–251. doi: 10.1111/j.1445-5994.1993.tb01725.x. [DOI] [PubMed] [Google Scholar]
  14. Kaasa T., Loomis J., Gillis K., Bruera E., Hanson J. The Edmonton Functional Assessment Tool: preliminary development and evaluation for use in palliative care. J Pain Symptom Manage. 1997 Jan;13(1):10–19. doi: 10.1016/s0885-3924(96)00206-0. [DOI] [PubMed] [Google Scholar]
  15. MacDonald N., Findlay H. P., Bruera E., Dudgeon D., Kramer J. A Canadian survey of issues in cancer pain management. J Pain Symptom Manage. 1997 Dec;14(6):332–342. doi: 10.1016/s0885-3924(97)00259-5. [DOI] [PubMed] [Google Scholar]
  16. McWhinney I. R., Bass M. J., Orr V. Factors associated with location of death (home or hospital) of patients referred to a palliative care team. CMAJ. 1995 Feb 1;152(3):361–367. [PMC free article] [PubMed] [Google Scholar]
  17. Pugh E. M. An investigation of general practitioner referrals to palliative care services. Palliat Med. 1996 Jul;10(3):251–257. doi: 10.1177/026921639601000310. [DOI] [PubMed] [Google Scholar]
  18. Seale C., Kelly M. A comparison of hospice and hospital care for people who die: views of the surviving spouse. Palliat Med. 1997 Mar;11(2):93–100. doi: 10.1177/026921639701100202. [DOI] [PubMed] [Google Scholar]
  19. Vainio A. Practising physicians' experiences of treating patients with cancer pain. Acta Oncol. 1989;28(2):177–182. doi: 10.3109/02841868909111243. [DOI] [PubMed] [Google Scholar]
  20. Wachtel T. J., Mor V. Physicians' use of health resources for terminal cancer patients: clinical setting versus physician specialty. South Med J. 1987 Sep;80(9):1120–1124. doi: 10.1097/00007611-198708090-00012. [DOI] [PubMed] [Google Scholar]

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