Po1739 Palliative Care And Family Medicine - The Need For A Closer Relationship

vitor coutinho1, Patricia Fernandes2, Margarida Fernandes3, Elizabete Coutinho, Herminio Araújo4 e Eduardo Duque5
1Unidade de Paliativos do Poverello; 2Unidade de Paliativos; 3Unidade de Paliativos "Poverello"; 4Unidade de Paliativos do "Poverello"; 5Universidade Católica Portuguesa
"The Poverello" (Braga), inserted in the RNCCI, is engaged in the care and clinical monitoring of patients in situations of incurable and progressive diseases. The Family Medicine demand, person centred, comprehensive and continuous, in the context of their families, communities and cultures. The aim of this study is to characterize the population that was hospitalized in the Unit during the first eighteen months as well as evaluating the different referral to this unit.
Methods: This is a simple descriptive statistical analysis and multivariate analysis (t-test and ANOVA). Data collection was done by computer system -GESTCARE, with the profile of patients characterized in a socio-demographic analyses. Evaluating control symptoms, performed by Edmonton Scale at baseline and at the last evaluation or discharge the patient. Data analysis and statistical analysis was performed using SPSS 21.0.
Results: 154 patients were admitted, with a predominance of male 53.2%. The mean age of the patients 69.3% with about 75 % of those over 60 years. The mean length of hospital in the Unit was 24 days and 49 % of users in the first 10 days, with 77 % less than 30 days. Regarding the provenance 129 patients (83.8%) were referred by the Hospital and 25 (16.2 %) by Primary Care. The main reason for leaving was death 94.8 %, and neoplasms 91.6 % in the main pathology admission. Most patients 93.5% died in the first 10 days, with 69.1 % of patient’s visits regularly. Admission rates and high patient were created and evaluated by ANOVA with repeated measures. Regarding the control of symptoms it is highlighted that the pain at baseline 64.3 % showed no pain/mild pain and 11.6% severe pain, the last assessment of pain was 66.9 % (0-3) and 7.1% several pain.
Discussion and Conclusion: Patients have been lately referred to the Palliative Unit, due to the short period of hospitalization. There is overall improvement in the symptomatic management of patients. There are no differences between days of hospitalization sent by the primary care and hospital, as well as the level of control of their symptoms. There are no differences between the rates of admission and leaving, according to provenance. Palliative Care is able to benefit patients and their families but it is necessary that patients for better control of symptoms and an early referral. The Family medicine should increase referral to these Units and should maintain this joint care, a close relationship.
Palliative Care; Family Medicine; Portuguese network of continuing care ; Edmonton Scale; Primary care; Palliative Care Unit