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- Title
Palliative Care for Patients With Hematologic Malignancies in a Low-Middle Income Country: Prevalence of Symptoms and the Need for Improving Quality of Attention at the End of Life.
- Authors
Jaime-Pérez, José Carlos; Turrubiates-Hernández, Grecia Abigayl; Nava-Obregón, Teresa; Coronado-Hernández, Blanca; Gutiérrez-Aguirre, Homero; Cantú-Rodríguez, Olga Graciela; Herrera-Garza, José Luis; Gómez-Almaguer, David
- Abstract
Background: Palliative care (PC) for patients with malignant hematological diseases is scarcely documented, particularly in low- and middle-income countries. This study aimed to document PC provided to patients with hematologic malignancies. Methods: Bidirectional study conducted from July 2016 to June 2019 at the hematology and palliative care departments at a reference center in Northeast Mexico for low-income open population uninsured patients. Clinical records and electronic files of patients with malignant hematological diseases of both sexes and all ages attending an academic hematology center were reviewed. Statistical analysis was performed with the SPSS version 22 program. Acute and chronic leukemias, multiple myeloma, Hodgkin lymphoma, non-Hodgkin lymphoma, and others were included. Results: Five-hundred ten patients were studied, of which 148 (29%) died. Eighty-one (15.88%) patients including 31 (20.9%) who died received PC. Median age at palliative diagnosis was 42 (2-91) years. The most common symptom was pain (69.7%). The most frequent reason for palliative referral was treatment-refractory disease (39%). During the last week of life, 19 (95%) of 20 patients had blood sampling; 17 (85%) received antibiotics; 16 (80%) had a urinalysis performed; 16 (80%) received analgesia, including paracetamol (11, 35.5%) and buprenorphine (7, 22.6%); 10 (50%) received blood products; 9 (45%) were intubated; and central venous catheters were inserted in 5 (25%) patients. Conclusions: Palliative care was provided to a minority of patients with hematologic malignancies and considerable improvement is required in its timely use and extension.
- Subjects
MEXICO; LEUKEMIA treatment; HODGKIN'S disease treatment; LYMPHOMA treatment; MULTIPLE myeloma treatment; ACADEMIC medical centers; ACETAMINOPHEN; ANTIBIOTICS; BLOOD testing; BLOOD transfusion; BUPRENORPHINE; CANCER pain; DISEASE complications; INCOME; LONGITUDINAL method; MEDICAL referrals; PALLIATIVE treatment; QUALITY assurance; URINALYSIS; QUANTITATIVE research; TREATMENT effectiveness; RETROSPECTIVE studies; CENTRAL venous catheters; DATA analysis software; ELECTRONIC health records; DESCRIPTIVE statistics; MIDDLE-income countries; LOW-income countries; HEMATOLOGIC malignancies; SYMPTOMS
- Publication
American Journal of Hospice & Palliative Medicine, 2020, Vol 37, Issue 8, p600
- ISSN
1049-9091
- Publication type
Article
- DOI
10.1177/1049909119887951