Palliative Home Visit Intervention and Emergency Admission in Pediatric Cancer Children: A Randomized Controlled Trial

Murti Andriastuti, Pricilia Gunawan Halim, Tati Mulyati, Meidiana Bangun, Dwi Putro Widodo

Research output: Contribution to journalArticlepeer-review

Abstract

Palliative care model can be carried out at home, in the community, or in long-term home care. Home visits in palliative care have an important role in providing continuity of care and psychosocial support to both the patient and their parents/caretakers. This study is aimed to determine the impact of home visit program to the frequency of emergency room (ER) admissions in children with cancer. Methods: Randomized controlled trial of 60 pediatric patients with malignancies who were given palliative care (a 3-months home visit) and those who were not was conducted. Patients were children with cancer aged 2-18 years old. Emergency room admissions from the last three months were recorded before patients were enrolled. A two-way communication between a trained health worker and patients with or without their parents were conducted as the intervention. Interventions were given in six sessions (1 session every 2 weeks). During study period, ER admissions were recorded further. Data was analyzed using bivariate analysis, OR calculations were performed. Results: In the intervention group, 11 children (36.7%) had fewer ER admissions, while 4 (13.3%) had more and 15 children (50%) had constant ER admissions, respectively. Meanwhile, only 2 children (7.7%) were found to have fewer ER admissions in the control group. Others in this group have varying results, 11 children (42.3%) were found to have more admissions to the ER and 13 children (50%) had constant ER admissions. In the intervention group, ER admissions were reduced by 10 visits, while in the control group, the admissions were increased by 16 visits (OR 4.77, 95% CI 1.29-17.65; p = 0.018). Conclusion: Palliative home visit provides care matched to patient and family needs, trained parents to be skillful in managing child, and enabling avoidance of unnecessary hospitalizations (4.7 times).

Original languageEnglish
Pages (from-to)194-199
Number of pages6
JournalCurrent Pediatric Reviews
Volume20
Issue number2
DOIs
Publication statusPublished - 2024

Keywords

  • cancer
  • children
  • emergency admission
  • Home visit
  • palliative
  • pediatric

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