Early identification for palliative care integration and symptom burden within family medicine practice in South India.

OBJECTIVES

This study aimed to identify patients with palliative care (PC) needs within Family Medicine Practice in the outpatient and inpatient settings, using the Supportive and Palliative Care Indicator Tool-Low-Income Settings (SPICT-LIS). The symptom burden among those identified with PC needs was also captured using the Palliative Care Assessment tool (PACA).

METHODOLOGY: This cross-sectional study included adults 18 years and above in the outpatient and inpatient settings of a Family Medicine Service Centre. All patients in the outpatient and inpatient settings were screened for the presence of chronic disease, and those with chronic disease were assessed using the SPICT-LIS tool to identify those with PC needs. The symptom burden of those identified was captured using the PACA tool.

RESULTS

Over a month (17 January-17 February 2024) 2009 patients (1956 outpatients and 53 inpatients) were screened. The majority (n=1659, 82.6%) had chronic diseases; 82.5% (n=1614) and 85% (n=45) in the outpatient and inpatient settings, respectively. Overall, PC needs were identified among 1.1% (n=18) of patients with chronic disease; 0.8% (n=13) and 11.1% (n=5) in the outpatient and inpatient settings, respectively.The median PACA score was 8 (range=2-26). The most common symptom among patients with PC needs was pain (61.1%).

CONCLUSION

SPICT-LIS was useful to identify patients with PC needs. PC needs were higher in the inpatient setting. Those with PC needs have a significant symptom burden. Early identification for PC integration within the primary PC is possible. This helps in providing better symptom relief.