Establishment of Integrated Hospital-Based Supportive and Palliative Services: An Experience from Iran
-
Mohammad Jahangiri
,
Suzanne Hojjat-Assari
,
Pooneh Pirjani
,
Mohammad Vaezi
,
Ghasem Janbabaei
,
Shayesteh Kokabi Hamidpour
,
Nafiseh Heidarzadeh Isfahani
,
Babak Arjmand
Abstract
Integrating supportive and palliative care into the oncology program is considered essential for effective cancer management. Despite the challenges that low- and middle-income countries such as Iran face in providing comprehensive supportive and palliative care services, continuous efforts are directed towards improving services and infrastructure. In this regard, the Iranian Cancer Control Center (MACSA) plays a fundamental role in providing supportive and palliative care with special emphasis on expanding services and ensuring equitable access for cancer patients in Iran. Through joint efforts with various organizations and hospitals, coupled with the implementation of effective leadership strategies, MACSA has tried to integrate its services into a referral hospital system in order to continuously improve and expand services and meet the multifaceted needs of patients and families affected by cancer. Indeed, MACSA's initiatives to embed supportive and palliative care within the framework of usual care in referral hospitals are critical in improving outcomes and quality of life for people battling cancer. The interdisciplinary nature of supportive and palliative care, involving a specialized team, is essential for efficient service delivery, cost-effectiveness, and overall quality of care.
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2. Wait S, Han D, Muthu V, et al. Towards sustainable cancer care: Reducing inefficiencies, improving outcomes—A policy report from the All. Can initiative. J Cancer Policy. 2017;13:47-64.
3. Farhood B, Geraily G, Alizadeh A. Incidence and Mortality of Various Cancers in Iran and Compare to Other Countries: A Review Article. Iran J Public Health. 2018;47(3):309-316.
4. Dare AJ, Knapp GC, Romanoff A, et al. High-burden Cancers in Middle-income Countries: A Review of Prevention and Early Detection Strategies Targeting At-risk Populations. Cancer Prev Res(Phila). 2021;14(12):1061-1074.
5. Hosseini LJ, Samadi AH, Woldemichael A, et al. Household Overcrowding in Iran, a Low-middle-income Country: How Major of a Public Health Concern Is It? J Prev Med Public Health. 2021;54(1):73-80.
6. World Health Organization IAfRoC, World Health Organization. . Global cancer observatory. https://gco.iarc.who.int/media/globocan/factsheets/populations/364-iran-islamic-republic-of-fact-sheet.pdf
7. You W, Henneberg M. Cancer incidence increasing globally: The role of relaxed natural selection. Evol Appl. 2017;11(2):140-152.
8. Dunn BK, Woloshin S, Xie H, et al. Cancer overdiagnosis: a challenge in the era of screening. J Natl Cancer Cent. 2022;2(4):235-242.
9. Williams AM, Bulsara CE, Petterson AS. Safety and side effects of non-pharmacological interventions as a therapy for cancer. Evidence-based non-pharmacological therapies for palliative cancer care. Springer; 2012:219-251.
10. Watson CJ. The ever‐expanding landscape of cancer therapeutic approaches. Wiley Online Library; 2021. p. 6082-6086.
11. Huff CA, Matsui W, Smith BD, et al. The paradox of response and survival in cancer therapeutics. Blood. 2006;107(2):431-434.
12. Zhang K, Shang B, Kellehear A, et al. Scope of Annals of Palliative Medicine based on a review of the disciplinary development and evolving definition of palliative medicine. Ann Palliat Med. 2023;12(6):1125-1131.
13. Hui D, Hoge G, Bruera E. Models of supportive care in oncology. Curr Opin Oncol. 2021;33(4):259-266.
14. Hui D, Bruera E. Models of palliative care delivery for patients with cancer. J Clin Oncol. 2020;38(9):852-865.
15. Hanks GW. Oxford textbook of palliative medicine. Oxford University Press, USA; 2011.
16. Barasteh S, Parandeh A, Rassouli M, et al. Integration of palliative care into the primary health care of iran: a document analysis. Middle East J Cancer. 2021;12(2):292-300.
17. Organization WH. Planning and implementing palliative care services: a guide for programme managers. https://iris.who.int/handle/10665/250584
18. Bakitas M, Bishop MF, Caron P, et al. Developing successful models of cancer palliative care services. Elsevier; 2010:266-284.
19. Hui D, Cherny NI, Wu J, et al. Indicators of integration at ESMO designated centres of integrated oncology and palliative care. ESMO Open. 2018;3(5):e000372.
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21. Kao CY, Hu WY, Chiu TY, et al. Effects of the hospital-based palliative care team on the care for cancer patients: an evaluation study. Int J Nurs stud. 2014;51(2):226-235.
22. Amroud MS, Raeissi P, Hashemi SM, et al. A comparative study of the status of supportive-palliative care provision in Iran and selected countries: Strengths and weaknesses. J Educ Health Promot. 2021;10:370.
23. Brant JM, Silbermann M. Global perspectives on palliative care for cancer patients: not all countries are the same. Curr Oncol Rep. 2021;23(5):60.
24. Levantini E. Cancer: A Multifaceted Enemy and the Precision Oncology Response. Int J Mol Sci. 2024;25(11):5577.
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26. Scotté F, Taylor A, Davies A. Supportive care: The “Keystone” of modern oncology practice. Cancers (Basel). 2023;15(15):3860.
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28. Hui D, Bruera E. Models of integration of oncology and palliative care. Ann Palliat Med. 2015;4(3):89-98.
29. Saga Y, Enokido M, Iwata Y, et al. Transitions in palliative care: conceptual diversification and the integration of palliative care into standard oncology care. Chin Clin Oncol. 2018;7(3):32.
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35. Grudzen CR, Barker PC, Bischof JJ, et al. Palliative care models for patients living with advanced cancer: a narrative review for the emergency department clinician. Emerg Cancer Care. 2022;1(1):10.
36. Hasson F, Jordan J, McKibben L, et al. Challenges for palliative care day services: a focus group study. BMC Palliat Care. 2021;20(1):11.
37. Pantilat SZ, Rabow MW, Kerr KM, et al. Palliative Care in California: The business case for hospital-based programs. Available from: https://www.chcf.org/wp-content/uploads/2017/12/PDF-PalliativeCareBusinessCase.pdf.
38. Rosenberg M, Rosenberg L. Integrated model of palliative care in the emergency department. West J Emerg Med. 2013;14(6):633-636.
39. Grudzen CR, Stone SC, Morrison RS. The palliative care model for emergency department patients with advanced illness. Journal of palliative medicine. 2011;14(8):945-950.
40. Heydari H, Hojjat-Assari S, Almasian M, et al. Exploring health care providers’ perceptions about home-based palliative care in terminally ill cancer patients. BMC Palliat Care. 2019;18(1):66.
41. Hojjat-Assari S, Pirjani P, Kaveh V, et al. Stakeholders’ perceptions of Home-based palliative care for Cancer patients during the COVID-19 pandemic: A qualitative study. J client- centered nurs care. 2023;9(1):35-46.
42. Sleeman KE, De Brito M, Etkind S, et al. The escalating global burden of serious health-related suffering: projections to 2060 by world regions, age groups, and health conditions. Lancet Global Health. 2019;7(7):e883-e892.
43. Bassah N, Vaughn L, Santos Salas A. Nurse‐led adult palliative care models in low‐and middle‐income countries: A scoping review. J Adv Nurs. 2023;79(11):4112-4126.
44. Bagheri I, Hashemi N, Bahrami M. Current state of palliative care in iran and related issues: A narrative eview. Iran J Nurs Midwifery Res. 2021;26(5):380-391.
45. Vaishya R, Vaish A. Trend of Publications from Iran in Orthopaedics and Sports Medicine. Arch Bone Jt Surg. 2024;12(1):75–77.
46. Connor S, Morris C, Jaramillo E, et al. Global Atlas of Palliative Care In: Connor SR, editor. 2nd ed. London: Worldwide Hospice Palliative Care Alliance; 2020.
47. Atena D, Imane B, Maryam R, et al. The level of knowledge about palliative care in Iranian patients with cancer. BMC Palliat Care. 2022;21(1):33.
48. Mojen LK. Palliative care in Iran: The past, the present and the future. Support Palliat Care Cancer. 2017;1(1):7-10.
49. MACSA. Available from: https://macsa.ir/en/
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51. Tehran University of Medical Sciences. https://en.tums.ac.ir/en/page/5/healthcare-in-tums
52. Jack B, Hillier V, Williams A, et al. Hospital based palliative care teams improve the insight of cancer patients into their disease. Palliat Med. 2004;18(1):46-52.
53. Jack B, Hillier V, Williams A, et al. Hospital based palliative care teams improve the insight of cancer patients into their disease. Palliat Med. 2004;18(1):46-52.
54. Rizvi F, Wilding HE, Rankin NM, et al. An evidence-base for the implementation of hospital-based palliative care programs in routine cancer practice: A systematic review. Palliat Med. 2023;37(9):1326-1344.
55. Valentijn PP, Schepman SM, Opheij W, et al. Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care. Int J Integr Care. 2013;13:e010.
56. Khanali-Mojen L, Akbari ME, Ashrafizadeh H, et al. Caregivers’ knowledge of and attitude towards palliative 1. Global cancer burden growing, amidst mounting need for services. 2024;
2. Wait S, Han D, Muthu V, et al. Towards sustainable cancer care: Reducing inefficiencies, improving outcomes—A policy report from the All. Can initiative. J Cancer Policy. 2017;13:47-64.
3. Farhood B, Geraily G, Alizadeh A. Incidence and Mortality of Various Cancers in Iran and Compare to Other Countries: A Review Article. Iran J Public Health. 2018;47(3):309-316.
4. Dare AJ, Knapp GC, Romanoff A, et al. High-burden Cancers in Middle-income Countries: A Review of Prevention and Early Detection Strategies Targeting At-risk Populations. Cancer Prev Res(Phila). 2021;14(12):1061-1074.
5. Hosseini LJ, Samadi AH, Woldemichael A, et al. Household Overcrowding in Iran, a Low-middle-income Country: How Major of a Public Health Concern Is It? J Prev Med Public Health. 2021;54(1):73-80.
6. World Health Organization IAfRoC, World Health Organization. . Global cancer observatory. https://gco.iarc.who.int/media/globocan/factsheets/populations/364-iran-islamic-republic-of-fact-sheet.pdf
7. You W, Henneberg M. Cancer incidence increasing globally: The role of relaxed natural selection. Evol Appl. 2017;11(2):140-152.
8. Dunn BK, Woloshin S, Xie H, et al. Cancer overdiagnosis: a challenge in the era of screening. J Natl Cancer Cent. 2022;2(4):235-242.
9. Williams AM, Bulsara CE, Petterson AS. Safety and side effects of non-pharmacological interventions as a therapy for cancer. Evidence-based non-pharmacological therapies for palliative cancer care. Springer; 2012:219-251.
10. Watson CJ. The ever‐expanding landscape of cancer therapeutic approaches. Wiley Online Library; 2021. p. 6082-6086.
11. Huff CA, Matsui W, Smith BD, et al. The paradox of response and survival in cancer therapeutics. Blood. 2006;107(2):431-434.
12. Zhang K, Shang B, Kellehear A, et al. Scope of Annals of Palliative Medicine based on a review of the disciplinary development and evolving definition of palliative medicine. Ann Palliat Med. 2023;12(6):1125-1131.
13. Hui D, Hoge G, Bruera E. Models of supportive care in oncology. Curr Opin Oncol. 2021;33(4):259-266.
14. Hui D, Bruera E. Models of palliative care delivery for patients with cancer. J Clin Oncol. 2020;38(9):852-865.
15. Hanks GW. Oxford textbook of palliative medicine. Oxford University Press, USA; 2011.
16. Barasteh S, Parandeh A, Rassouli M, et al. Integration of palliative care into the primary health care of iran: a document analysis. Middle East J Cancer. 2021;12(2):292-300.
17. Organization WH. Planning and implementing palliative care services: a guide for programme managers. https://iris.who.int/handle/10665/250584
18. Bakitas M, Bishop MF, Caron P, et al. Developing successful models of cancer palliative care services. Elsevier; 2010:266-284.
19. Hui D, Cherny NI, Wu J, et al. Indicators of integration at ESMO designated centres of integrated oncology and palliative care. ESMO Open. 2018;3(5):e000372.
20. (who) Who. Hospital-based palliative care services bridge the care gap in Lebanon. https://www.emro.who.int/noncommunicable-diseases/highlights/hospital-based-palliative-care-services-bridge-the-care-gap-in-lebanon.html.
21. Kao CY, Hu WY, Chiu TY, et al. Effects of the hospital-based palliative care team on the care for cancer patients: an evaluation study. Int J Nurs stud. 2014;51(2):226-235.
22. Amroud MS, Raeissi P, Hashemi SM, et al. A comparative study of the status of supportive-palliative care provision in Iran and selected countries: Strengths and weaknesses. J Educ Health Promot. 2021;10:370.
23. Brant JM, Silbermann M. Global perspectives on palliative care for cancer patients: not all countries are the same. Curr Oncol Rep. 2021;23(5):60.
24. Levantini E. Cancer: A Multifaceted Enemy and the Precision Oncology Response. Int J Mol Sci. 2024;25(11):5577.
25. Jordan K, Aapro M, Kaasa S, et al. European Society for Medical Oncology (ESMO) position paper on supportive and palliative care. Ann Oncol. 2018;29(1):36-43.
26. Scotté F, Taylor A, Davies A. Supportive care: The “Keystone” of modern oncology practice. Cancers (Basel). 2023;15(15):3860.
27. Hassankhani H, Rahmani A, Taleghani F, et al. Palliative care models for cancer patients: Learning for planning in nursing. J Cancer Educ. 2020;35(1):3-13.
28. Hui D, Bruera E. Models of integration of oncology and palliative care. Ann Palliat Med. 2015;4(3):89-98.
29. Saga Y, Enokido M, Iwata Y, et al. Transitions in palliative care: conceptual diversification and the integration of palliative care into standard oncology care. Chin Clin Oncol. 2018;7(3):32.
30. Mathews J, Hannon B, Zimmermann C. Models of integration of specialized palliative care with oncology. Curr Treat Options Oncol. 2021;22(5):44.
31. Meier DE, McCormick E, Arnold R, et al. Benefits, services, and models of subspecialty palliative care. Uptodate. Available from: https://www.uptodate.com/contents/benefits-services-and-models-of-subspecialty-palliative-care
32. Wiencek C, Coyne P. Palliative Care Delivery Models. Semin Oncol Nurs. 2014;30(4):227-233.
33. van Doorne I, Willems DL, Baks N, et al. Current practice of hospital-based palliative care teams: Advance care planning in advanced stages of disease: A retrospective observational study. Plos One. 2024;19(2):e0288514.
34. Sullender RT, Selenich SA. Financial Considerations of Hospital-Based Palliative Care [Internet]. RTI Press; 2016 Mar.
35. Grudzen CR, Barker PC, Bischof JJ, et al. Palliative care models for patients living with advanced cancer: a narrative review for the emergency department clinician. Emerg Cancer Care. 2022;1(1):10.
36. Hasson F, Jordan J, McKibben L, et al. Challenges for palliative care day services: a focus group study. BMC Palliat Care. 2021;20(1):11.
37. Pantilat SZ, Rabow MW, Kerr KM, et al. Palliative Care in California: The business case for hospital-based programs. Available from: https://www.chcf.org/wp-content/uploads/2017/12/PDF-PalliativeCareBusinessCase.pdf.
38. Rosenberg M, Rosenberg L. Integrated model of palliative care in the emergency department. West J Emerg Med. 2013;14(6):633-636.
39. Grudzen CR, Stone SC, Morrison RS. The palliative care model for emergency department patients with advanced illness. Journal of palliative medicine. 2011;14(8):945-950.
40. Heydari H, Hojjat-Assari S, Almasian M, et al. Exploring health care providers’ perceptions about home-based palliative care in terminally ill cancer patients. BMC Palliat Care. 2019;18(1):66.
41. Hojjat-Assari S, Pirjani P, Kaveh V, et al. Stakeholders’ perceptions of Home-based palliative care for Cancer patients during the COVID-19 pandemic: A qualitative study. J client- centered nurs care. 2023;9(1):35-46.
42. Sleeman KE, De Brito M, Etkind S, et al. The escalating global burden of serious health-related suffering: projections to 2060 by world regions, age groups, and health conditions. Lancet Global Health. 2019;7(7):e883-e892.
43. Bassah N, Vaughn L, Santos Salas A. Nurse‐led adult palliative care models in low‐and middle‐income countries: A scoping review. J Adv Nurs. 2023;79(11):4112-4126.
44. Bagheri I, Hashemi N, Bahrami M. Current state of palliative care in iran and related issues: A narrative eview. Iran J Nurs Midwifery Res. 2021;26(5):380-391.
45. Vaishya R, Vaish A. Trend of Publications from Iran in Orthopaedics and Sports Medicine. Arch Bone Jt Surg. 2024;12(1):75–77.
46. Connor S, Morris C, Jaramillo E, et al. Global Atlas of Palliative Care In: Connor SR, editor. 2nd ed. London: Worldwide Hospice Palliative Care Alliance; 2020.
47. Atena D, Imane B, Maryam R, et al. The level of knowledge about palliative care in Iranian patients with cancer. BMC Palliat Care. 2022;21(1):33.
48. Mojen LK. Palliative care in Iran: The past, the present and the future. Support Palliat Care Cancer. 2017;1(1):7-10.
49. MACSA. Available from: https://macsa.ir/en/
50. Dastjerdi MV. On the Occasion of 75th Anniversary of the Establishment of Tehran University of Medical Sciences. International Affairs Office (International Branch) Tehran University of Medical Sciences; 2009.
51. Tehran University of Medical Sciences. https://en.tums.ac.ir/en/page/5/healthcare-in-tums
52. Jack B, Hillier V, Williams A, et al. Hospital based palliative care teams improve the insight of cancer patients into their disease. Palliat Med. 2004;18(1):46-52.
53. Jack B, Hillier V, Williams A, et al. Hospital based palliative care teams improve the insight of cancer patients into their disease. Palliat Med. 2004;18(1):46-52.
54. Rizvi F, Wilding HE, Rankin NM, et al. An evidence-base for the implementation of hospital-based palliative care programs in routine cancer practice: A systematic review. Palliat Med. 2023;37(9):1326-1344.
55. Valentijn PP, Schepman SM, Opheij W, et al. Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care. Int J Integr Care. 2013;13:e010.
56. Khanali-Mojen L, Akbari ME, Ashrafizadeh H, et al. Caregivers’ knowledge of and attitude towards palliative care in Iran. Asian Pac J of Cancer Prev. 2022;23(11):3743-3751.
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2. Wait S, Han D, Muthu V, et al. Towards sustainable cancer care: Reducing inefficiencies, improving outcomes—A policy report from the All. Can initiative. J Cancer Policy. 2017;13:47-64.
3. Farhood B, Geraily G, Alizadeh A. Incidence and Mortality of Various Cancers in Iran and Compare to Other Countries: A Review Article. Iran J Public Health. 2018;47(3):309-316.
4. Dare AJ, Knapp GC, Romanoff A, et al. High-burden Cancers in Middle-income Countries: A Review of Prevention and Early Detection Strategies Targeting At-risk Populations. Cancer Prev Res(Phila). 2021;14(12):1061-1074.
5. Hosseini LJ, Samadi AH, Woldemichael A, et al. Household Overcrowding in Iran, a Low-middle-income Country: How Major of a Public Health Concern Is It? J Prev Med Public Health. 2021;54(1):73-80.
6. World Health Organization IAfRoC, World Health Organization. . Global cancer observatory. https://gco.iarc.who.int/media/globocan/factsheets/populations/364-iran-islamic-republic-of-fact-sheet.pdf
7. You W, Henneberg M. Cancer incidence increasing globally: The role of relaxed natural selection. Evol Appl. 2017;11(2):140-152.
8. Dunn BK, Woloshin S, Xie H, et al. Cancer overdiagnosis: a challenge in the era of screening. J Natl Cancer Cent. 2022;2(4):235-242.
9. Williams AM, Bulsara CE, Petterson AS. Safety and side effects of non-pharmacological interventions as a therapy for cancer. Evidence-based non-pharmacological therapies for palliative cancer care. Springer; 2012:219-251.
10. Watson CJ. The ever‐expanding landscape of cancer therapeutic approaches. Wiley Online Library; 2021. p. 6082-6086.
11. Huff CA, Matsui W, Smith BD, et al. The paradox of response and survival in cancer therapeutics. Blood. 2006;107(2):431-434.
12. Zhang K, Shang B, Kellehear A, et al. Scope of Annals of Palliative Medicine based on a review of the disciplinary development and evolving definition of palliative medicine. Ann Palliat Med. 2023;12(6):1125-1131.
13. Hui D, Hoge G, Bruera E. Models of supportive care in oncology. Curr Opin Oncol. 2021;33(4):259-266.
14. Hui D, Bruera E. Models of palliative care delivery for patients with cancer. J Clin Oncol. 2020;38(9):852-865.
15. Hanks GW. Oxford textbook of palliative medicine. Oxford University Press, USA; 2011.
16. Barasteh S, Parandeh A, Rassouli M, et al. Integration of palliative care into the primary health care of iran: a document analysis. Middle East J Cancer. 2021;12(2):292-300.
17. Organization WH. Planning and implementing palliative care services: a guide for programme managers. https://iris.who.int/handle/10665/250584
18. Bakitas M, Bishop MF, Caron P, et al. Developing successful models of cancer palliative care services. Elsevier; 2010:266-284.
19. Hui D, Cherny NI, Wu J, et al. Indicators of integration at ESMO designated centres of integrated oncology and palliative care. ESMO Open. 2018;3(5):e000372.
20. (who) Who. Hospital-based palliative care services bridge the care gap in Lebanon. https://www.emro.who.int/noncommunicable-diseases/highlights/hospital-based-palliative-care-services-bridge-the-care-gap-in-lebanon.html.
21. Kao CY, Hu WY, Chiu TY, et al. Effects of the hospital-based palliative care team on the care for cancer patients: an evaluation study. Int J Nurs stud. 2014;51(2):226-235.
22. Amroud MS, Raeissi P, Hashemi SM, et al. A comparative study of the status of supportive-palliative care provision in Iran and selected countries: Strengths and weaknesses. J Educ Health Promot. 2021;10:370.
23. Brant JM, Silbermann M. Global perspectives on palliative care for cancer patients: not all countries are the same. Curr Oncol Rep. 2021;23(5):60.
24. Levantini E. Cancer: A Multifaceted Enemy and the Precision Oncology Response. Int J Mol Sci. 2024;25(11):5577.
25. Jordan K, Aapro M, Kaasa S, et al. European Society for Medical Oncology (ESMO) position paper on supportive and palliative care. Ann Oncol. 2018;29(1):36-43.
26. Scotté F, Taylor A, Davies A. Supportive care: The “Keystone” of modern oncology practice. Cancers (Basel). 2023;15(15):3860.
27. Hassankhani H, Rahmani A, Taleghani F, et al. Palliative care models for cancer patients: Learning for planning in nursing. J Cancer Educ. 2020;35(1):3-13.
28. Hui D, Bruera E. Models of integration of oncology and palliative care. Ann Palliat Med. 2015;4(3):89-98.
29. Saga Y, Enokido M, Iwata Y, et al. Transitions in palliative care: conceptual diversification and the integration of palliative care into standard oncology care. Chin Clin Oncol. 2018;7(3):32.
30. Mathews J, Hannon B, Zimmermann C. Models of integration of specialized palliative care with oncology. Curr Treat Options Oncol. 2021;22(5):44.
31. Meier DE, McCormick E, Arnold R, et al. Benefits, services, and models of subspecialty palliative care. Uptodate. Available from: https://www.uptodate.com/contents/benefits-services-and-models-of-subspecialty-palliative-care
32. Wiencek C, Coyne P. Palliative Care Delivery Models. Semin Oncol Nurs. 2014;30(4):227-233.
33. van Doorne I, Willems DL, Baks N, et al. Current practice of hospital-based palliative care teams: Advance care planning in advanced stages of disease: A retrospective observational study. Plos One. 2024;19(2):e0288514.
34. Sullender RT, Selenich SA. Financial Considerations of Hospital-Based Palliative Care [Internet]. RTI Press; 2016 Mar.
35. Grudzen CR, Barker PC, Bischof JJ, et al. Palliative care models for patients living with advanced cancer: a narrative review for the emergency department clinician. Emerg Cancer Care. 2022;1(1):10.
36. Hasson F, Jordan J, McKibben L, et al. Challenges for palliative care day services: a focus group study. BMC Palliat Care. 2021;20(1):11.
37. Pantilat SZ, Rabow MW, Kerr KM, et al. Palliative Care in California: The business case for hospital-based programs. Available from: https://www.chcf.org/wp-content/uploads/2017/12/PDF-PalliativeCareBusinessCase.pdf.
38. Rosenberg M, Rosenberg L. Integrated model of palliative care in the emergency department. West J Emerg Med. 2013;14(6):633-636.
39. Grudzen CR, Stone SC, Morrison RS. The palliative care model for emergency department patients with advanced illness. Journal of palliative medicine. 2011;14(8):945-950.
40. Heydari H, Hojjat-Assari S, Almasian M, et al. Exploring health care providers’ perceptions about home-based palliative care in terminally ill cancer patients. BMC Palliat Care. 2019;18(1):66.
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| Files | ||
| Issue | Vol 20 No 1 (2026): Articles In Press | |
| Section | Review Article(s) | |
| Keywords | ||
| Cancer; Hospital-based; Integrated; Palliative care; Supportive care | ||
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How to Cite
1.
Jahangiri M, Hojjat-Assari S, Pirjani P, Vaezi M, Janbabaei G, Kokabi Hamidpour S, Heidarzadeh Isfahani N, Arjmand B. Establishment of Integrated Hospital-Based Supportive and Palliative Services: An Experience from Iran. Int J Hematol Oncol Stem Cell Res. 2026;20(1).
