Clinical findings and recommendations made during home visits by a palliative care specialist physician

Little has been reported regarding the nature of home visits by palliative care specialist physicians to assist in the management of complex cases. We determined the characteristics, actionable clinical findings and recommendations made during consecutive home visits conducted by a specialist physic...

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Bibliographic Details
Published in:Palliative medicine 2009-10, Vol.23 (7), p.635-641
Main Authors: Bush, SH, Wearne, HJ, Reilly, PE, Chacko, R, Palmer, JL
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Analgesics, Opioid - administration & dosage
Cancer
Child
Child, Preschool
Clinical guidelines
Community Health Nursing - standards
Community Health Nursing - statistics & numerical data
Doctors
Domiciliary visits
Family physicians
Female
Home Care Services - standards
Home Care Services - statistics & numerical data
House Calls - statistics & numerical data
Humans
Infant
Infant, Newborn
Integrated delivery systems
Interdisciplinary aspects
Male
Medical referrals
Middle Aged
Nurses
Nursing care
Nursing homes
Oral Hygiene
Palliative care
Palliative Care - standards
Palliative Care - statistics & numerical data
Patient care
Patients
Practice Patterns, Physicians
Retrospective Studies
Teams
Victoria
Young Adult
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Summary:Little has been reported regarding the nature of home visits by palliative care specialist physicians to assist in the management of complex cases. We determined the characteristics, actionable clinical findings and recommendations made during consecutive home visits conducted by a specialist physician for patients registered with a community palliative care service. Patient demographic information and clinical records were reviewed. Ninety-one patients received a total of 104 home and residential facility visits. Median patient age was 59 (Q1—Q3, 43—72). Ten children (under the age of 14) received a total of 15 visits. Seventy-three patients (80%) had a cancer diagnosis. Median visit duration was 60 min (Q1—Q3, 45—60). The major actionable clinical findings were pain (120), gastrointestinal (115), neuropsychiatric (58), mouth and skin (33) and respiratory (29). One-third of recommendations involved changes in analgesia regimen (opioids 67, adjuvants 44). The specialist physician home visit resulted in multiple patient care recommendations. This information may help palliative care programmes improve their care for patients and families in the community.
ISSN:0269-2163
1477-030X
DOI:10.1177/0269216309106752