Impact of a multi‐professional expert team on EOL care of children with cancer. Issue 12 (22nd November 2021)

• Record Type: Journal Article
• Authors: Iwamoto, Shotaro; Hori, Hiroki; Sakata, Keiko; Kawamata, Ayumi; Suefuji, Miki; Igura, Chika; Yodoya, Noriko; Matsubara, Takako; Ogura, Toru; Komada, Yoshihiro; Hirayama, Masahiro
• Is Part Of: Pediatrics international. Volume 63:Issue 12(2021)
• Page Start: 1451
• Page End: 1457
• Publication Date: 2021-11-22
• Subjects: end‐of‐life care -- home‐based care -- multi‐professional expert team -- pediatric cancer -- pediatric palliative care; Pediatrics -- Periodicals; 618.92
• DOI: 10.1111/ped.14626
• Languages: English
• ISSNs: 1328-8067

Abstract

Abstract: Background: The quality of end‐of‐life (Q‐EOL) care is influenced by various factors such as resources for palliative care (PC). We introduced a multi‐professional expert team (MET) in 2014, which provides home‐based care for children and adolescents with incurable cancer. This study investigated the impacts of the outreach activities by the MET on Q‐EOL care of pediatric oncology patients. Methods: This observational study retrospectively examined 112 patients receiving end‐of‐life care between 1989 and 2018 at a pediatric cancer center in Japan. Some of the indicators of Q‐EOL care before and after the introduction of the outreach activities by the MET were compared. The subjects were 92 in pre‐MET and 20 in post‐MET periods. Results: The median number of days for which the patients stayed at home during the final seven or 30 days were significantly prolonged in the post‐MET period (0.0 vs 1.5 days, P = 0.020, 3.0 vs 12.0 days, P = 0.042). The change was more significant in hematologic malignancies than solid and central nervous system tumors. Patients receiving longer PC before their deaths could stay at home longer during the last 7 days. The ratio of patients receiving PC for more than 2 months was significantly increased in post‐MET period (60.9 vs 90.0%, P = 0.014). More patients also greeted their deaths at home in the post‐MET period (3.3 vs 25.0%, P < 0.001). Conclusions: The activities of the MET transformed the end‐of‐life care of children and adolescents with incurable cancer. Earlier transitions to PC from curative treatment were associated with longer home‐based care and more deaths at home.