INITIAL DEMOGRAPHIC, SYMPTOM, AND MEDICATION PROFILES IN PATIENTS ADMITTED TO CONTINUING PALLIATIVE CARE UNITS

We retrospectively reviewed 110 consecutive admissions to continuing p alliative care units, which were designed as part of a regionalized, c omprehensive palliative care program in Edmonton, Canada. Ninety-six p atient charts met the criteria for evaluation. Demographic characteris tics, and when available, symptom profiles, cognitive status, and risk for a history of substance abuse were described. The medications on a dmission were tabulated and in those 93 patients who had consults done by a palliative care consultant, these are compared to recommended me dications. This study showed an older cohort of patient (mean +/- SD = 75 +/- 11 years) than had previously been described in a tertiary uni t in the same community. Median length of stay was 21 days (range, 0-> 200 days). Cognitive impairment was higher than would be anticipated o n the basis of age alone, with 32/47 [64% (confidence interval {CI} 55 %-81%)] of patients who had had cognitive testing done on the day of c onsult being found to be cognitively impaired. Symptoms, as measured b y the Edmonton Symptom Assessment Scale, were similar to those found f or patients admitted to the tertiary palliative care unit. In the 93 p atients who had palliative care consults done oil admission, there wer e a total of 179 recommendations for medication or hydration changes. Overall compliance with these recommendations was 84% (CI, 79%-89%). T he highest compliance was observed for recommendations to start hydrat ion clysis [27/27 100% (CI, 100%)], and the lowest rate was observed f or altering or decreasing hypnotic medications [11/22, 50%(CI, 29%-71% )]. We conclude that the patients were of highs? acuity than anticipat ed. (C) U.S. Cancer Pain Relief Committee, 1998.