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Education may ensure integration of palliative care
An early and integrated approach is necessary to help make sure clinicians do not miss opportunities to provide palliative care services to patients with advanced cancer, particularly those with hematologic malignancies, according to findings of a retrospective study.
Sun Hyun Kim, MD, and colleagues from The University of Texas MD Anderson Cancer Center reviewed the charts of 1,995 consecutive patients with cancer at their center who died between September 2009 and March 2010.
They used the data to determine the proportion of referrals to palliative care, as well as to compare the differences between patients who died with and without receiving palliative care.
Of the patients studied, 539 (38%) received palliative care consultations. A multivariate logistic regression analysis showed age (P<.001), race (P=.005), marital status (P=.001), education level (P=.030) and cancer type (P=.001) were significantly associated with referral to palliative care services.
Hematologic patients had the longest median time intervals from diagnosis of advanced cancer to death (741 days) and diagnosis of advanced cancer to palliative care referral (782 days).
Hematologic patients also had the shortest median time interval from palliative care referral to death (18 days) and the highest median number of encounters with members of the primary oncology team (45 days) before palliative care referral.
“We found many missed opportunities for early and multidisciplinary palliative care consultations,” the researchers wrote.
More specific targeted education about how to integrate palliative care into active primary oncology are needed for all clinicians who care for patients with advanced cancer and, specifically, those in hematology departments who may care for the most vulnerable group of patients, the researchers concluded.
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