{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T11:56:36Z","timestamp":1723290996295},"reference-count":37,"publisher":"Scientific Scholar","content-domain":{"domain":["jpalliativecare.com"],"crossmark-restriction":true},"short-container-title":["IJPC"],"abstract":"\nObjectives:<\/jats:title>\nPalliative care (PC) referral in serious and critical COVID-19 improves decision-making, health resource utilisation, end-of-life symptom management and family support. In this study, we explored developing a systematic decision-making matrix for PC referral in COVID-19 and audited its outcomes.<\/jats:p>\n<\/jats:sec>\n\nMaterials and Methods:<\/jats:title>\nA team of interdisciplinary experts developed a hospital COVID-19 PC plan. PC referral and outcomes of PC referral in hospitalised COVID-19 patients were audited.<\/jats:p>\n<\/jats:sec>\n\nResults:<\/jats:title>\nOut of 1575 inpatients, 1066 (67.7%) had mild and 509 (32.3%) had serious and critical COVID-19 illness. Among 50 (3.1%) referred to PC, 5 (0.4%) had mild and 45 (8.8%) had serious and critical COVID-19 illness. Out of 45 serious and critical COVID-19 patients referred to PC, 38 (84%) received end-of-life care (EOLC), 4 (9%) self-discharged against medical advice and 3 (7%) recovered. Forty-seven (94%) were referred for goals-of-care discussion. About 78% received opioids, 70% benzodiazepines and 42% haloperidol for symptom management. Among 45 serious and critical COVID-19 patients referred to PC, foregoing life-sustaining treatment was documented in 43 (96%) but implemented only in 23 (53%). Out of 38 who received EOLC, ICU was the place of death in 31 (82%) and ward in 7 (18%).<\/jats:p>\n<\/jats:sec>\n\nConclusion:<\/jats:title>\nDespite interdisciplinary experts developing a hospital COVID-19 PC, low referral of serious and critical COVID-19 patients to PC was observed. PC referral enabled access to management of end-of-life symptoms and facilitated limitation of life-sustaining treatment in some COVID-19 patients with serious illness. Educating critical care physicians about the scope of PC in the COVID-19 setting might improve PC referral.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/ijpc_59_2021","type":"journal-article","created":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T08:47:59Z","timestamp":1635410879000},"page":"272-279","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["COVID-19 Palliative and End-of-Life Care Plan: Development and Audit of Outcomes"],"prefix":"10.25259","volume":"28","author":[{"given":"Seema Rajesh","family":"Rao","sequence":"first","affiliation":[{"name":"Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krithika S.","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pankaj","family":"Singhai","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayank","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shwetapriya","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vishal","family":"Shanbhag","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayaraj Mymbilly","family":"Balakrishnan","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raviraja V.","family":"Acharya","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muralidhar","family":"Varma","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kavitha","family":"Saravu","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul","family":"Munikrishna","sequence":"additional","affiliation":[{"name":"Department of Healthcare Operations, Kasturba Hospital, Manipal, Karnataka, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jibu","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Healthcare Operations, Kasturba Hospital, Manipal, Karnataka, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. 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