緩和ケアと医学

抽象的な

Effectiveness of a Geriatrics and Palliative Care Consultation on Symptom Management and Geriatric Syndromes

Angelica E Davila1, Jeanette S Ross, Scotte Hartronft, Mary Garza, Shuko Lee and Sandra Sanchez-Reilly*

With the increase in geriatric patientsand the wide spectrum of their illnesses, geriatricians and palliative care physicians would benefit from combining their expertise in treating chronically and terminally ill elder patients in a hospital setting. The objective of our pilot study was to determine if a Geriatric Palliative Care consult could improve pain management and prevent geriatric syndromes in elder patients. Our data was collected from a retrospective chart review of subjects older than 65 years-old who received combined Geriatrics and Palliative Care consult from a combined Geriatrics Palliative Care team. Previously validated instruments identified pain score and level of comorbidity. A total of 60 charts were reviewed. Results showed a Geriatric Palliative Care consultation lowered pain score from pre-consult to post-consult (2.63 vs. 1.17; p=0.012) and effectively improved pain in 20% of subjects (41.7% vs. 21.7%; p=0.002). The Geriatric Palliative Care consult team effectively lowered the in-hospital complication of restraints (11.7% vs. 3.3%; p=0.025) and also had a positive effect on delirium and advance directives (p=0.5). In conclusion, Geriatric Palliative Care consults have shown to improve the quality of care for older adults by effectively managing pain symptoms and improving pain scores among 20% of the subjects.