Specialist palliative and end-of-life care for patients with cancer and SARS-CoV-2 infection: a European perspective. (September 2021)

• Record Type: Journal Article
• Authors: Soosaipillai, Gehan; Wu, Anjui; Dettorre, Gino M; Diamantis, Nikolaos; Chester, John; Moss, Charlotte; Aguilar-Company, Juan; Bower, Mark; Sng, Christopher CT; Salazar, Ramon; Brunet, Joan; Jones, Eleanor; Mesia, Ricard; Jackson, Amanda; Mukherjee, Uma; Sita-Lumsden, Ailsa; Seguí, Elia; Ottaviani, Diego; Carbó, Anna; Benafif, Sarah; Würstlein, Rachel; Carmona, Carme; Chopra, Neha; Cruz, Claudia Andrea; Swallow, Judith; Saoudi, Nadia; Felip, Eudald; Galazi, Myria; Garcia-Fructuoso, Isabel; Lee, Alvin J. X.; Newsom-Davis, Thomas; Wong, Yien Ning Sophia; Sureda, Anna; Maluquer, Clara; Ruiz-Camps, Isabel; Cabirta, Alba; Prat, Aleix; Loizidou, Angela; Gennari, Alessandra; Ferrante, Daniela; Tabernero, Josep; Russell, Beth; Van Hemelrijck, Mieke; Dolly, Saoirse; Hulbert-Williams, Nicholas J; Pinato, David J;
• Other Names: Mollà Meritxell non-byline-author.; Reyes Roxana non-byline-author.; Marco-Hernández Javier non-byline-author.; Bruna Riccardo non-byline-author.; Biello Federica non-byline-author.; Patriarca Andrea non-byline-author.; Zambelli Alberto non-byline-author.; Tondini Carlo non-byline-author.; Fotia Vittoria non-byline-author.; Chiudinelli Lorenzo non-byline-author.; Franchi Michela non-byline-author.; Generali Daniele non-byline-author.; Grisanti Salvatore non-byline-author.; Tovazzi Valeria non-byline-author.; Bertuzzi Alexia non-byline-author.; Marrari Andrea non-byline-author.; Seeva Pavetha non-byline-author.; Dileo Palma non-byline-author.; Rizzo Gianpiero non-byline-author.; Libertini Michela non-byline-author.; Maconi Antonio non-byline-author.; Betti Marta non-byline-author.; Provenzano Salvatore non-byline-author.; Harbeck Nadia non-byline-author.; Vincenzi Bruno non-byline-author.; Bertulli Rossella non-byline-author.; Liñan Raquel non-byline-author.; Roqué Ariadna non-byline-author.; Mirallas Oriol non-byline-author.; García-Illescas David non-byline-author.; Scotti Lorenza non-byline-author.; Dalla Pria Alessia non-byline-author.; D'Avanzo Francesca non-byline-author.; Martinez Maria non-byline-author.; Evans Joanne S non-byline-author.; Sharkey Rachel non-byline-author.; Rimassa Lorenza non-byline-author.; Santoro Armando non-byline-author.; Gaidano Gianluca non-byline-author.; Izuzquiza Macarena non-byline-author.;
• Is Part Of: Therapeutic advances in medical oncology. Volume 13(2021)
• Publication Date: 2021-09
• Subjects: cancer -- COVID-19 -- end-of-life (EOL) -- end-of life care (EOLC) -- speciality palliative care team (SPCT); Oncology -- Periodicals; Cancer -- Treatment -- Periodicals; 616.994005
• DOI: 10.1177/17588359211042224
• Languages: English
• ISSNs: 1758-8340

Abstract

Background: Specialist palliative care team (SPCT) involvement has been shown to improve symptom control and end-of-life care for patients with cancer, but little is known as to how these have been impacted by the COVID-19 pandemic. Here, we report SPCT involvement during the first wave of the pandemic and compare outcomes for patients with cancer who received and did not receive SPCT input from multiple European cancer centres. Methods: From the OnCovid repository ( N = 1318), we analysed cancer patients aged ⩾18 diagnosed with COVID-19 between 26 February and 22 June 2020 who had complete specialist palliative care team data (SPCT+ referred; SPCT− not referred). Results: Of 555 eligible patients, 317 were male (57.1%), with a median age of 70 years (IQR 20). At COVID-19 diagnosis, 44.7% were on anti-cancer therapy and 53.3% had ⩾1 co-morbidity. Two hundred and six patients received SPCT input for symptom control (80.1%), psychological support (54.4%) and/or advance care planning (51%). SPCT+ patients had more 'Do not attempt cardio-pulmonary resuscitation' orders completed prior to (12.6% versus 3.7%) and during admission (50% versus 22.1%, p < 0.001), with more SPCT+ patients deemed suitable for treatment escalation (50% versus 22.1%, p < 0.001). SPCT involvement was associated with higher discharge rates from hospital for end-of-life care (9.7% versus 0%, p < 0.001). End-of-life anticipatory prescribing was higher in SPCT+ patients, with opioids (96.3% versus 47.1%) and benzodiazepines (82.9% versus 41.2%) being used frequently for symptom control. Conclusion: SPCT referral facilitated symptom control, emergency care and discharge planning, as well as high rates of referral for psychological support than previously reported. Our study highlighted the critical need of SPCTs for patients with cancer during the pandemic and should inform service planning for this population.