121 Indwelling intraperitoneal catheter service improving symptoms in the last 9 weeks of life

<h3>Background</h3> The Northumbria specialist palliative care hospital liaison team (HLT) has developed a service to enable the insertion and management of permanent abdominal intraperitoneal catheters (IPCs). Research in other sites¹ has shown a reduction in hospital admissions, improved quality of life and may support patients to be in their preferred place of care and/or death. This study reports on the change in IPOS² scores before and after insertion and demonstrates the intervention to be of value in improving patient symptoms. <h3>Method</h3> 41 Patients who attended for IPC insertion were supported to complete an IPOS questionnaire by a member of the HLT during a face-to-face assessment. A telephone assessment took place two weeks after the insertion and the IPOS questionnaire was repeated. <h3>Results</h3> 41 patients had an IPC inserted between January 2019 and January 2024. 36 had malignant ascites, 5 had non-malignant ascites. 31 Had an IPOS completed before and after insertion. Those who didn’t complete an IPOS; 5 were uncontactable post-insertion, 1 was out of area, 4 deteriorated rapidly and died. 7 developed an infection which required antibiotics, without removal of the IPC. The mean time between insertion and death was 64 days (range 8–262). The longest period an IPC stayed in was 262 days. While the IPOS questionnaire demonstrated high symptom need in several domains, the most frequent symptoms patients reported as either ‘severe’ or ‘overwhelming’2 were pain, nausea and weakness. 2 weeks after IPC insertion there was a reduction in the experience of pain (69% improvement), nausea (57% improvement) and weakness (66% improvement). <h3>Conclusion</h3> This study shows an improvement in patient reported symptoms following abdominal IPC insertion for patients with recurrent ascites. The mean time from insertion to death of 64 days makes this an important intervention to optimise symptom control in the last weeks of life. <h3>References</h3> Jackson K, Frew K, Johnston R, Coleman J, Armstrong L, Aujayeb A. Indwelling peritoneal catheter for ascites management in a UK district general hospital: a cohort study. <i>Healthcare (Basel)</i> 2021;<b>9</b>(10):1254. doi: 10.3390/healthcare9101254. PMID: 34682934; PMCID: PMC8536105. Palliative care Outcome Scale (POS) - Home (pos-pal.org) Accessed 16/10/24