The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK.
Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
Clin Oncol (R Coll Radiol). 2023 Jun;35(6):e395-e403. doi: 10.1016/j.clon.2023.03.002. Epub 2023 Mar 11.
Improvements in cancer treatment have led to more people living with and beyond cancer. These patients have symptom and support needs unmet by current services. The development of enhanced supportive care (ESC) services may meet the longitudinal care needs of these patients, including at the end of life. This study aimed to determine the impact and health economic benefits of ESC for patients living with treatable but not curable cancer.
A prospective observational evaluation was undertaken over 12 months across eight cancer centres in England. ESC service design and costs were recorded. Data relating to patients' symptom burden were collected using the Integrated Palliative Care Outcome Scale (IPOS). For patients in the last year of life, secondary care use was compared against an NHS England published benchmark.
In total, 4594 patients were seen by ESC services, of whom 1061 died during follow-up. Mean IPOS scores improved across all tumour groups. In total, £1,676,044 was spent delivering ESC across the eight centres. Reductions in secondary care usage for the 1061 patients who died saved a total of £8,490,581.
People living with cancer suffer with complex and unmet needs. ESC services appear to be effective at supporting these vulnerable people and significantly reduce the costs of their care.
癌症治疗的进步使得越来越多的人能够与癌症共存并生存下去。这些患者的症状和支持需求未得到当前服务的满足。增强型支持性护理(ESC)服务的发展可能满足这些患者的纵向护理需求,包括生命末期。本研究旨在确定 ESC 对患有可治疗但不可治愈癌症的患者的影响和健康经济效益。
在英格兰的八个癌症中心进行了为期 12 个月的前瞻性观察评估。记录了 ESC 服务的设计和成本。使用综合姑息治疗结局量表(IPOS)收集与患者症状负担相关的数据。对于生命的最后一年的患者,将二级护理的使用情况与英格兰国民保健制度公布的基准进行了比较。
共有 4594 名患者接受了 ESC 服务,其中 1061 名在随访期间死亡。所有肿瘤组的 IPOS 评分均有所改善。八个中心共花费 1676044 英镑提供 ESC。1061 名死亡患者的二级护理使用量减少,总共节省了 8490581 英镑。
患有癌症的人会遭受复杂且未得到满足的需求。ESC 服务似乎能够有效地支持这些弱势群体,并显著降低他们的护理成本。