Quality of Life, Pain Perception, and Distress Correlated to Ultrasound-Guided Peripherally Inserted Central Venous Catheters in Palliative Care Patients in a Home or Hospice Setting

• Published in: Journal of pain and symptom management 2015-07, Vol.50 (1), p.118-123
• Main Authors: Bortolussi, Roberto, MD, Zotti, Paola, PhD, Conte, Maria, MD, Marson, Rita, RN, Polesel, Jerry, ScD, Colussi, Annamaria, RN, Piazza, Donatella, RN, Tabaro, Gianna, BSc, Spazzapan, Simon, MD
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Anesthesia & Perioperative Care; Central venous catheters; Central Venous Catheters - adverse effects; Female; Follow-Up Studies; Home Care Services; Hospice Care - methods; Hospice Care - psychology; Humans; Italy; Male; Pain Medicine; Pain Perception; palliative care; Palliative Care - methods; Palliative Care - psychology; PICC; Prospective Studies; quality of life; Quality of Life - psychology; Stress, Psychological - etiology; Treatment Outcome; Ultrasonography, Interventional - adverse effects; Ultrasonography, Interventional - methods; Ultrasonography, Interventional - psychology
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2015.02.027

Abstract Context Intravenous fluid administration with peripherally inserted central venous catheters (PICCs) and midline catheters in palliative care. Objectives To evaluate distress and pain perceived by patients during the positioning of a PICC or midline catheter, both in the home and hospice settings. Methods This was a prospective observational study performed by the Palliative Care Network of Pordenone. In addition to evaluating distress and pain, we monitored patient quality of life and the devices used. Quality of life was measured with the European Organization for Research and Treatment of Cancer-Core 15-Palliative scale. Results From May 2012 to July 2013, 48 patients were enrolled in the study. The level of distress during the procedure was null or very low in 95.8% of the patients and completely absent after one week. Pain during insertion was null or very little in 93.8% of the patients and zero after one week in 98% of the patients. Quality of life was significantly improved after one week for certain specific parameters and also globally. The number of catheter days monitored was 3097. The weekly monitoring of the devices revealed a series of minor complications. Only two catheters were removed for serious complications. Conclusion Our results showed a low impact on pain and distress, a low level of local and systemic complications and a favorable impact on patients' quality of life. However, other studies are necessary to evaluate the cost-effectiveness of the use of these devices and their role in palliative care.