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Integrated Hospital- and Home-Based Palliative Care for Cancer Patients in Vietnam: People-Centered Outcomes.

Authors
  • Nguyen, Viet1
  • Khanh, Quach Thanh2
  • Hocaoglu, Mevhibe3
  • Huyen, Hoang Thi Mong2
  • Thinh, Dang Huy Quoc2
  • Krakauer, Eric L4
  • 1 Swedish First Hill Family Medicine Residency (V.N.), Seattle, Washington, USA.
  • 2 Ho Chi Minh City Oncology Hospital (Q.T.K., H.T.M.H., D.H.Q.T.), Ho Chi Ming City , Vietnam.
  • 3 Cicely Saunders Institute (M.H.), King's College London, UK; Department of Global Health & Social Medicine (M.H., E.L.K.), Harvard Medical School, Boston, Massachusetts, USA. Electronic address: [email protected].
  • 4 Department of Global Health & Social Medicine (M.H., E.L.K.), Harvard Medical School, Boston, Massachusetts, USA; University of Medicine & Pharmacy at Ho Chi Minh City (E.L.K.), Ho Chi Minh City, Vietnam.
Type
Published Article
Journal
Journal of pain and symptom management
Publication Date
Sep 01, 2023
Volume
66
Issue
3
Identifiers
DOI: 10.1016/j.jpainsymman.2023.04.016
PMID: 37119878
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Hospital-based palliative care (PC) linked to palliative home care is rarely accessible in low- and middle-income countries (LMICs). To study people-centered outcomes of a palliative home care team based at a major cancer center in Vietnam. The palliative home care team, consisting of at least one physician and one nurse, provided home PC when needed by patients of the cancer center who lived within 10 kilometers. A linguistically validated version of the African Palliative Outcomes Scale was integrated into standard clinical data collection. We retrospectively reviewed data from the 81 consecutive patients on prevalence and severity of pain and other types of physical, psycho-social, and spiritual suffering at the first home visit (baseline) and at the first follow-up visit and measured any differences. There was great demand for palliative home care. From baseline to follow-up, there was significant improvement in pain regardless of the baseline severity of pain (p < 0.003). Among patients with severe pain, breathlessness, nausea/vomiting, diarrhea, depression, or worry about illness at baseline, there was significant improvement (p < 0.001), and caregiver worry about the patient also improved significantly. Integration of hospital- and home-based PC for cancer patients is feasible and improves people-centered outcomes at low cost in Vietnam. These data suggest that benefits to patients, their families, and the health care system can accrue from integration of PC at all levels in Vietnam and other LMICs. Copyright © 2023. Published by Elsevier Inc.

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