Abstract
Background
The goal of palliative care (PC) is to reduce suffering and improve quality of life for patients with life-limiting illnesses and their families. Prior studies consistently demonstrate high symptom burden among PC patients; however, most evidence comes from cancer populations outside the US, leaving a gap in large-scale US data across disease groups.
Methods
We conducted a retrospective cohort study using quality metrics from a large, nonprofit hospice agency in the US Northeast. The study included 5871 patients who received palliative care services and had at least one Edmonton Symptom Assessment Scale (ESAS) assessment between July 2022 and December 2023. Five symptoms are described by severity on a 0-10 scale in a sample with malignant and non-malignant diagnoses.
Results
We observed high prevalence of pain (34.3%), anxiety (32.3%), and dyspnea (28.0%) at first consultation. Many patients also reported moderate (4-6) or severe (7-10) intensity for pain (17.6% and 16.7%, respectively). Symptom burden also varied across disease groups: patients with solid tumors (63.3%) and liver disease (57.5%) exhibited particularly high rates of pain, while heart (46.9%) and lung disease (66.8%) exhibited high dyspnea. Among the 2852 patients with repeated consultations, there was substantial symptom improvement for pain (33.1% of patients), anxiety (22.1%), and dyspnea (19.3%).
Conclusion
Palliative care patients experience high symptom burden, varying by diagnosis. Planning access to tailored PC services to meet varying physical and emotional needs at a population level remains critical.
Keywords
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