Home-Based Palliative Care for Patients With Non-Cancer Diagnoses: Clinical Characteristics, Symptom Burden, and Service Delivery

IntroductionPopulation aging has contributed to the increased prevalence of chronic non-communicable and disabling diseases, increasing the demand for home-based palliative care.ObjectiveTo describe the sociodemographic, clinical, and care profile of patients with non-cancer treated by a Home Care Service in Palliative Care (SAD-CP) of the Unified Health System, who died within 10 years.MethodsThis is a cross-sectional study based on the analysis of medical records of non-oncology patients treated by a SAD-CP in Brazil. Sociodemographic, clinical, functional, and service-use-related variables were collected. Variables were used in absolute and relative frequencies, and medians and interquartile ranges. Survival analysis included the Kaplan-Meier curve.ResultsAmong the 248 patients included, the main referral reasons to SAD-CP were neurological (25.4%) and circulatory (21.7%). The mean age was 80.8 years, with most patients being female (50.8%). At admission, 45.5% had a PPS score ≤30. The median length of stay was 50 days. Care was marked by frequent visits, with medians of 1.74 regular (scheduled), 1.25 nursing, 0.49 medical, and 0.18 emergency (unplanned) visits per day. All patients died at home, with deaths distributed evenly throughout the day.ConclusionPatients with non-cancer conditions admitted to SAD-CP care often present with a high burden of comorbidities and marked functional impairment. The association between lower PPS scores and higher service intensity highlights the need to adapt care to functional status and prognosis. With multidisciplinary support, home death can be successfully achieved. These findings underscore the urgency of strengthening public policies and expanding palliative care services.

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Publication Details

Journal
American Journal of Hospice and Palliative Medicine®
Published
2025-09-19
DOI
https://doi.org/10.1177/10499091251382180
Citations
1
Primary Topic
Palliative Care and End-of-Life Issues
Type
article
Field-Weighted Citation Impact
1.88
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article

Home-Based Palliative Care for Patients With Non-Cancer Diagnoses: Clinical Characteristics, Symptom Burden, and Service Delivery

Mônica Isaura Corrêa, Igor de Oliveira Claber Siqueira, Ana Paula Drummond‐Lage, Sônia Buongermino de Souza et al.
1 citations
American Journal of Hospice and Palliative Medicine®
Palliative Care and End-of-Life Issues
1.88
article

Home-Based Palliative Care for Patients With Non-Cancer Diagnoses: Clinical Characteristics, Symptom Burden, and Service Delivery

Mônica Isaura Corrêa, Igor de Oliveira Claber Siqueira, Ana Paula Drummond‐Lage, Sônia Buongermino de Souza, Eduardo Bruera
article en
1 citations

Abstract

IntroductionPopulation aging has contributed to the increased prevalence of chronic non-communicable and disabling diseases, increasing the demand for home-based palliative care.ObjectiveTo describe the sociodemographic, clinical, and care profile of patients with non-cancer treated by a Home Care Service in Palliative Care (SAD-CP) of the Unified Health System, who died within 10 years.MethodsThis is a cross-sectional study based on the analysis of medical records of non-oncology patients treated by a SAD-CP in Brazil. Sociodemographic, clinical, functional, and service-use-related variables were collected. Variables were used in absolute and relative frequencies, and medians and interquartile ranges. Survival analysis included the Kaplan-Meier curve.ResultsAmong the 248 patients included, the main referral reasons to SAD-CP were neurological (25.4%) and circulatory (21.7%). The mean age was 80.8 years, with most patients being female (50.8%). At admission, 45.5% had a PPS score ≤30. The median length of stay was 50 days. Care was marked by frequent visits, with medians of 1.74 regular (scheduled), 1.25 nursing, 0.49 medical, and 0.18 emergency (unplanned) visits per day. All patients died at home, with deaths distributed evenly throughout the day.ConclusionPatients with non-cancer conditions admitted to SAD-CP care often present with a high burden of comorbidities and marked functional impairment. The association between lower PPS scores and higher service intensity highlights the need to adapt care to functional status and prognosis. With multidisciplinary support, home death can be successfully achieved. These findings underscore the urgency of strengthening public policies and expanding palliative care services.

American Journal of Hospice and Palliative Medicine®
The University of Texas MD Anderson Cancer Center (US), Centro Universitário de Caratinga (BR), Faculdade de Ciências Médicas de Minas Gerais (BR), Biostatistical Consulting (United States) (US)
Openalex Percentile: Top 12%
Palliative Care and End-of-Life Issues
1.88
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