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13. Evidence-based physiotherapy interventions: evaluation of current practice in a palliative care service.

Author

Pennycooke, Linda, Cree, Rosalind, Fischer, Amanda, and Good, Phillip

Subjects
PHYSICAL therapy, AUDITING, LYMPHEDEMA, PALLIATIVE treatment, EXERCISE, FUNCTIONAL assessment, RISK management in business, COMMUNITIES, FUNCTIONAL status, DESCRIPTIVE statistics, STRENGTH training, LONGITUDINAL method, QUALITY of life, EVIDENCE-based medicine, COMPARATIVE studies, PALLIATIVE medicine, TIME, PHYSICAL mobility, ACCIDENTAL falls
Abstract

Maintaining independence and quality of life are significant issues for patients with a life-limiting illness and physiotherapists play an essential role in the palliative care multidisciplinary team in maintaining, restoring, and improving physical function and quality of life (QOL). This study aims to describe current physiotherapy interventions utilized in a palliative care service and compare it to the evidence base of physiotherapy interventions in palliative care. An audit was conducted of all inpatient and community palliative care patients referred for physiotherapy review and intervention, over a 4-week period. A literature search was conducted and the level of evidence for individual physiotherapy interventions was assessed. The audit identified 35 patients referred to the Physiotherapist for the assessment and management of mobility, falls risk management and prevention, lymphoedema management and assessment of functional decline. The most frequently performed physiotherapy assessments and interventions were for mobility and transfer (94.3%), falls prevention and management (74.3%), reconditioning and strengthening (57.1%), and exercise prescription (48.6%). Physiotherapy in the palliative care setting is becoming more accepted to help benefit the function and QOL of patients with advanced progressive diseases. This audit highlights the importance of these interventions in assisting patients to manage their symptoms and function at home. [ABSTRACT FROM AUTHOR]

Published
2024
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21. Impact of the COVID-19 pandemic on the use of an inpatient and community palliative care service.

Author

Doo, Irene, Fischer, Amanda, Griffin, Alison, and Good, Phillip

Subjects
COMMUNITY health services, MEDICAL care use, AUDITING, PALLIATIVE treatment, T-test (Statistics), MEDICAL quality control, HOSPITAL care, MEDICAL care, FISHER exact test, LOGISTIC regression analysis, RETROSPECTIVE studies, CHI-squared test, MANN Whitney U Test, DESCRIPTIVE statistics, TELEMEDICINE, MEDICAL consultation, ELECTRONIC health records, PUBLIC health, COVID-19 pandemic, SOCIAL distancing, MEDICAL referrals
Abstract

Background: The COVID-19 pandemic disrupted the usual provision of healthcare, changing models of care, clinical loads, service provision and patient behaviour. Aims: This study assesses the impact of COVID-19 on community and inpatient palliative care service provision. Methods: A retrospective audit and comparison of service use conducted over two defined periods, before and during the COVID-19 pandemic, 2019–2020. Findings: The community palliative care service had a 9% increase in referrals, with a lower proportion of referrals (2.4%) from subacute/palliative care hospitals during the COVID-19 pandemic. Provision of care during the pandemic included less face-to-face contact with patients (24.1% versus 30.2% before), and markedly more contact with patients via videoconference (2.1% versus 0.1% before the pandemic). Conclusion: The community specialist palliative care service was busier during the pandemic period, and experienced a shift in mode of care delivery, while the inpatient unit experienced no difference in service use. [ABSTRACT FROM AUTHOR]

Published
2024
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31. Drug dependence epidemiology in palliative care medicinal cannabis trials

Author

Lee, Chee Yen, Good, Phillip, Huggett, Georgie, Greer, Ristan, and Hardy, Janet

Abstract

ObjectivesDrug dependence is becoming increasingly common and meeting palliative care patients with substance use disorders is inevitable. However, data on substance use in these patients are lacking. This study aims to evaluate the prevalence of drug dependence in palliative care patients with advanced cancer and correlate with symptom distress and opioid use.MethodsPalliative care patients with advanced cancer interested in participation in a medicinal cannabis trial were required to complete Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Edmonton Symptom Assessment Scale (ESAS) and record of concomitant medications including baseline opioid use as part of the eligibility screen.ResultsOf the 182 participants, 167 (92%) reported lifetime alcohol and 132/182 (73%) lifetime tobacco use. No participant reached the threshold criteria for high risk of drug dependence with majority being low risk. There was no correlation between ASSIST score, ESAS and oral morphine equivalent.ConclusionThis study identified alcohol and tobacco as the main substances used in this group of patients and that most were of very low risk for drug dependence. This suggests routine drug screening for palliative care patient may not be justified, but the high possibility of questionnaire bias is acknowledged.

Published
2024
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