PALliative Care Yields Cancer welLbEing Support

Challenge: many patients with advanced cancer in the final phase of life leave the hospital without continuity of information, and certainty about further treatment and care provision.

Often, communication between healthcare providers in different settings is suboptimal and this leads to poor continuity and coordination of care, negatively impacting the quality of life and increasing preventable hospital admissions.

Solution: the PAL-CYCLES programme: a transitional palliative care programme for patients with advanced cancer, adaptable to local cultures and healthcare systems.

The programme contains an intervention aiming for a smooth transition from hospital care to community care, consisting of five cornerstone components: (1) identification of a patient with palliative and supportive care needs in collaboration with the oncologist and the hospital palliative care team; (2) compassionate communication towards the patient and their family; (3) a collaborative multidimensional care plan and follow-up in the home care setting; (4) periodic evaluation of the care plan with patients and relatives; (5) identification of the terminal phase (if there) based on the periodic evaluations, with appropriate intensification of care and end-of-life talks depending on local possibilities and habits, including consultation with patient and families about ethically and legally sensitive issues.

Plan: we intend to develop, adapt, implement, and evaluate the PAL-CYCLES programme in seven European countries using a stepped wedge randomized controlled trial design.

Patient, relatives, and health care provider experiences, as well as ethical and equity issues will be addressed with qualitative methods.

Impact: the PAL-CYCLES programme will facilitate patient-centred communication and continuity of palliative cancer care in the community care setting, reducing unplanned hospital admissions and improving quality of life for patients with advanced cancer at the end of life.