Evaluation of Services of a Multidisciplinary Team for Supportive and Palliative Care for Persons with Advanced Cancer at the Tertiary Hospital in Croatia over First Three years: A Retrospective Study.

Abstract

Supportive and palliative care, delivered by a multidisciplinary team, plays a crucial role in improving the quality of life for people with advanced cancer by addressing physical, psychological, and social needs. There are no published data evaluating the work of such teams in tertiary care settings in Croatia. This study aimed to evaluate the services of a multidisciplinary supportive and palliative care team for persons with advanced cancer at a tertiary hospital in Croatia over the first three years of its work. A retrospective observational study was conducted at the University Hospital Centre Zagreb, Croatia. Data were retrieved from the electronic health records of adult patients with cancer treated by the multidisciplinary supportive and palliative care team between March 2022 and March 2025. Patient demographics, diagnoses, treatment interventions, symptom management, and health care utilization were extracted and analyzed. During the study period, 476 patients were referred to the palliative care team (median age 67; 52% women). At referral, 95% had metastatic disease, and 93% had moderate-to-severe functional impairment. The most severe symptoms were fatigue, pain, lack of appetite, and drowsiness. Median time from admission to referral was six days (range 0-47) and from referral to death was 23 days (0-1022). Persons with cancer were referred to a multidisciplinary supportive and palliative care team with advanced metastatic disease, poor functional status, and high symptom burden. The severity of needs at the first consultation indicates that referrals often occurred too late for patients to fully benefit from palliative care. These findings highlight the need to integrate palliative care earlier within oncology pathways.