Palliative care consultations for non-malignant diseases: Experience from a public hospital in Western India.

Abstract

Palliative care (PC) consultation has been shown to improve patient's quality of life (QoL), reduce symptom burden, decrease hospital stay, and provide holistic care for patients with life-limiting diseases. To asses impact of palliative medicine consultation in symptom management in patients with non-oncological medical conditions in a tertiary care hospital. A record based study with study period of six months, from August 2021 to January 2022 was conducted. Patients with complete record were included for analysis. Included patients above 18 years of age with a non-oncological medical conditions referred for a newly established palliative medicine clinic in a tertiary care hospital. A total of 83 patient records were analyzed, of which 30 (36.1%) were female and 53 (63.9%) were male. Among patients referred for Palliative Medicine consultation, 38 (45.8%) had neurological disease, followed by chronic renal diseases in 31 (37.3%) patients. There was a statistically significant improvement in the Edmonton Symptom Assessment System (ESAS) score on the follow-up visit. Discussion regarding Do Not Resuscitate (DNR) status was conducted in 20% of patients, and all patients or their families consented to the directive. Home-based Palliative Care arrangements were provided for 10% of patients. Palliative Medicine consultation brought about a significant reduction in anxiety and fatigue among patients with non-oncological medical conditions. It also helped in reducing the severity of symptoms in these patients.