Longitudinal palliative care delivery in oncology in a resource-constrained setting: Experience from 1,500 patients in Albania.

Abstract

e24077 Background: Early integration of palliative care is a core component of high-quality oncology care; however, access and structured integration remain limited in resource-limited settings. In Albania, patients with advanced cancer frequently present with a high symptom burden and are often managed in emergency or intensive care units due to the lack of dedicated palliative care services, highlighting a significant gap in quality cancer care. Methods: We conducted a retrospective descriptive analysis of oncology patients longitudinally followed by the same medical oncologist between 2014 and 2025. A total of 1,500 patients receiving palliative-oriented oncology care were included. Data collected included primary tumor type and age-group distribution. Based on identified unmet needs, a pilot inpatient palliative care consultation service was designed at a tertiary university hospital in Albania. Results: Between 2014 and 2025, 1,500 patients were longitudinally followed within a palliative care framework. The most common tumor types were lung, gastrointestinal, breast, and genitourinary cancers, with representation of less frequent malignancies. The majority of patients were aged ≥65 years, reflecting a population with complex symptom burden, multiple comorbidities, and increased care needs. These findings identified critical gaps in inpatient symptom management and end-of-life care delivery. To address these gaps, a six-month multidisciplinary pilot inpatient palliative care consultation service was developed, aiming to improve symptom control, provide psychosocial support, facilitate goals-of-care discussions, and reduce potentially avoidable intensive care unit admissions. Conclusions: This real-world longitudinal experience demonstrates substantial palliative care needs among oncology patients in a resource-limited setting. The observed patient characteristics underscore the urgency of structured palliative care integration. Implementation of a pilot inpatient palliative care consultation service represents a feasible and scalable quality-of-care intervention, with the potential to improve patient outcomes, optimize resource utilization, and support sustainable integration of palliative care into routine oncology practice.