Title:Palliative Home Visit Intervention and Emergency Admission in Pediatric
Cancer Children: A Randomized Controlled Trial
Volume: 20
Issue: 2
Author(s): Murti Andriastuti*, Pricilia Gunawan Halim, Tati Mulyati, Meidiana Bangun and Dwi Putro Widodo
Affiliation:
- Department of Child Health, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Keywords:
Home visit, emergency admission, palliative, pediatric, cancer, children.
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).
