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

SH Bush

South East Palliative Care, Cranbourne Integrated Care Centre, Cranbourne, Melbourne, Victoria, sbush{at}bruyere.org, Department of Palliative Care and Rehabilitation Medicine (Unit 8), UT M. D. Anderson Cancer Center, Houston, Texas

HJ Wearne

South East Palliative Care, Cranbourne Integrated Care Centre, Cranbourne, Melbourne, Victoria

PE Reilly

South East Palliative Care, Cranbourne Integrated Care Centre, Cranbourne, Melbourne, Victoria

R Chacko

Department of Palliative Care and Rehabilitation Medicine (Unit 8), UT M. D. Anderson Cancer Center, Houston, Texas

JL Palmer

Department of Palliative Care and Rehabilitation Medicine (Unit 8), UT M. D. Anderson Cancer Center, Houston, Texas

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.

Key Words: house calls • palliative care • patient care team • physicians

This version was published on October 1, 2009

Palliative Medicine, Vol. 23, No. 7, 635-641 (2009)
DOI: 10.1177/0269216309106752
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