Oral Presentations O-1 ENHANCED SUPPORTIVE CARE IN CANCER 1,2 Richard Berman, 1 Elizabeth Elliott, 1 Lisa LaMola, 1 Carole Mula, 1 Hannah Talbot, 1 Sacha Kong, 1 Wendy Makin, 1 Julian Scott-Warren. 1 The Christie NHS Foundation Trust, Manchester, UK; 2 NHS England, UK 10.1136/bmjspcare-2017-00133.1 Background Enhanced Supportive Care (ESC) is a fresh approach to supporting people through cancer treatment. At its heart is better and earlier access to expertise in managing the adverse effects of cancer and cancer treatments. ESC is recognised nationally by NHS England, and received a Quality in Care (QiC) award (February 2016). Methods In (2012–2015), The Christie NHS Foundation Trust (a major cancer centre) piloted ESC across 4 cancer disease groups (skin, breast, hepatobiliary, upper GI). We provided appropriate supportive care treatments, at an early stage, for patients who were starting to develop problems with pain or symptoms, related to their cancer or cancer treatments. We also worked with oncologists to improve communication with primary care teams. In order to facilitate early involvement, we rebranded and changed the name of our team from ‘pal- liative care team’ to ‘supportive care team’. Results A reduction was seen in the relative number of emer- gency admissions in disease groups where there has been sig- nificant ESC support. Such reductions were not seen consistently in those disease groups that did not receive signif- icant ESC support. This reduction in emergency admissions suggested a potential £1.38m saving over a three year period. ESC also demonstrated improved patient and carer experience. Patients benefitted from being presented information in a hopeful and positive way. The initiative was warmly welcomed by colleagues in oncology. Conclusion The landscape of cancer is changing due to better treatments. More and more people are living longer with chronic cancer. In line with emerging research on the benefits of early palliative/supportive care, ESC demonstrates improved quality and reduction in overall healthcare costs. The reduc- tion in emergency admissions may reflect early detection and management of symptom problems, preventing these from escalating. The next phase of ESC broadens access to suppor- tive care through integration with acute oncology and devel- opment of local ambulatory ESC units. O-2 CANCER RELATED INSOMNIA: WIRELESS MONITORING OF SLEEP METRICS 1,2 Brenda O’Connor, 1 Pauline Uí Dhuibhir, 1 Stephen Higgins, 1 Lucy Balding, 1 Norma O’Leary, 1,2,3 Declan Walsh. 1 Our Lady’s Hospice and Care Services, Dublin, Ireland; 2 School of Medicine, Trinity College Dublin; 3 UCD School of Medicine and Medical Sciences, University College Dublin 10.1136/bmjspcare-2017-00133.2 Background Insomnia involves difficulty with sleep onset, maintenance, early morning wakening or non-restorative sleep. Prevalence is 30%–75% in cancer. Consequences include fatigue and impaired memory or concentration. It is under- reported, overlooked and severely impairs quality of life. Subjective sleep diaries underestimate insomnia. Objective measurements previously required dedicated sleep laboratories. Wireless medical technology enables objective sleep measure- ment in the natural environment. Aims . Conduct a feasibility study to examine if a wireless monitor can measure sleep in cancer. . Evaluate acceptability in: a. Patient b. Nurse c. Family . Correlate objective device results with subjective reports. Methods A prospective observational study recruited 10 con- secutive hospice inpatients (IP) and 20 consecutive community participants (CP) with cancer. Insomnia Severity Index recorded subjective sleep pattern. Participants used a wireless non-contact bedside sleep monitor for 3 nights. Three insom- nia features were examined (sleep onset, maintenance, early awakening). A daily sleep diary was completed. Acceptability questionnaires were completed by patient, nurse and family. Statistical analysis was undertaken with SPSS version 22. Results The device successfully recorded sleep patterns in all 30 participants. Inpatients: Mean age was 63 years (range 47– 61). 7/10 were positive for one or more insomnia features. Delayed sleep onset was most common (7/10). Community Participants: Mean age was 64 years (range 47–84). 15/20 were positive for one or more insomnia features. Fragmented sleep was most common. 14/20 recorded over 30 min awake overnight with more than 2 awakenings. Early morning wak- ening was not present in either cohort. Poor sleep hygiene was noted in community participants compared to inpatients. Correlation between subjective and objective measures was not significant (IP: p=0.07; CP: p=0.106). Patients, nurses and family members reported 100% device acceptability. Conclusions 1. A wireless bedside monitor effectively measures sleep in cancer. 2. High patient acceptability supports clinical use. 3. Cancer-related insomnia features were common in both cohorts. 4. Objective measurements correlated poorly with subjective. O-3 OPIOIDS, BENZODIAZEPINES, ANTI-CHOLINERGIC LOAD AND CLINICAL OUTCOMES IN PATIENTS WITH ADVANCED CANCER 1 Jason W Boland, 2 Victoria Allgar, 1,3 Elaine G Boland, 1 Osaretin Oviasu, 4,5,6 Meera Agar, 1,4,5 David C Currow, 1 Miriam J Johnson. 1 Hull York Medical School, University of Hull, Hull, UK; 2 University of York, York, UK; 3 Hull and East Yorkshire Hospitals NHS Trust, Hull, UK; 4 University of Technology Sydney, Sydney, Australia; 5 Discipline, Palliative and Supportive Services, Flinders University, Adelaide, South Australia; 6 Ingham Institute of Applied Medical Research, Sydney, Australia 10.1136/bmjspcare-2017-00133.3 Background Medications used to manage symptoms in patients with cancer have associated, but poorly understood, harms. The aim of this study was to explore the temporal relation- ship between oral morphine equivalent daily dose (MEDD), oral diazepam equivalent daily dose (DEDD) and the daily anti-cholinergic load (ACL) with cognitive and gastrointestinal symptoms, performance status, quality of life and survival in patients receiving palliative care. Methods Secondary longitudinal analysis of cancer decedents (n=235) from a palliative care trial with multiple outcome Abstracts BMJ Supportive & Palliative Care 2017;7(Suppl 1):A1–A54 A1 on June 14, 2020 by guest. Protected by copyright. http://spcare.bmj.com/ BMJ Support Palliat Care: first published as 10.1136/bmjspcare-2017-00133.3 on 1 March 2017. Downloaded from