Palliative consultations improve outcomes — study

Broad impact’ on patient care possible

Palliative care consultations can lead to improved patient outcomes, including relief of dyspnea, anxiety, and sleeplessness, and may reduce the number of times patients must seek primary or urgent care, according to a new study.

The study, conducted by researchers at the University of California-San Francisco and published in the Archives of Internal Medicine, tracked seriously ill UCSF outpatients whose primary care physicians requested palliative care consultations for patients with cancer, advanced congestive heart failure, or chronic obstructive pulmonary disease, and who had a one- to five-year prognosis. The study was conducted as part of the Robert Wood Johnson Foundation’s Promoting Excellence in End-of-Life Care program, through the Department of Medicine and the Institute for Health and Aging at UCSF.

"We saw improvements despite the fact recommendations from the palliative care team were only partly adopted by the patients’ physicians," says study co-author Michael Rabow, MD, associate professor of clinical medicine at UCSF. "More widespread support for, and adoption of, palliative care principles — especially pain management and treatment for depression — has the potential to yield broader impact on patient care.

Palliative care aims to relieve suffering and to support the best possible quality of life for patients with advanced, chronic, or life-threatening illnesses and their families. It focuses on treating pain, symptoms, and stress, providing support for daily living, helping patients and families make difficult medical decisions, and ensuring patient and family wishes for care are followed.

UCSF was recently awarded a $700,000 grant from the Robert Wood Johnson Foundation to become one of six Palliative Care Leadership Centers. The aim of the Palliative Care Leadership Center Initiative is to increase the availability of palliative care in hospitals throughout the nation by bringing institutions to learn from exemplary palliative care programs in settings similar to their own. The UCSF Comfort Care Consultation Service and Suites specializes in palliative care within an academic teaching hospital setting and provides multidisciplinary palliative care consultations as well as operating an acute inpatient palliative care unit within the hospital.