This article is more than 5 years old. Information may no longer be current.
Lack of transfusion capabilities linked to underuse of hospice for blood cancers
Click Here to Manage Email Alerts
Hematologic oncologists appeared to value hospice but may be concerned about the adequacy of services like transfusion for patients with blood cancers, thus limiting referrals, according to study results published in Cancer.
“Our findings are important as they shed light on factors that are potential barriers to hospice referrals,” Oreofe O. Odejide, MD, instructor of medicine at Harvard Medical School and physician at Dana-Farber Cancer Institute, said in a press release. “These findings can be employed to develop targeted interventions to address hospice underuse for patients with blood cancers.”
Although hospice is an important aspect of end-of-life care, patients with hematologic malignancies have the lowest rates of hospice use of all oncology patients.
Few studies have examined the cause for these low rates, including whether hematologic oncologists’ views about the utility of hospice could partially explain the low rate of referrals.
Odejide and colleagues conducted a mailed survey of 667 randomly selected hematologic oncologists in the United States to characterize this group’s perspectives on the utility of hospice.
Of these, 349 hematologic oncologists replied (response rate, 57.3%), most of whom (68.1%) strongly agreed that hospice care is useful for patients with hematologic cancers.
Hematologic oncologists whose practices included at least 25% of patients with solid tumors appeared more likely to strongly agree about the utility of hospice (OR = 2.1; 95% CI, 1.26-3.52).
Still, 46% of respondents felt that home hospice cannot adequately meet patients’ needs compared with inpatient hospice.
Hematologic oncologists said they agreed or strongly agreed they would refer more patients to hospice if they could have regular clinic visits after hospice begins (26.8%) or if hospice allowed for red cell or platelet transfusions (61.7%).
A greater proportion of those who considered hospice inadequate reported they would refer more patients if red cell (67.3% vs. 55.3%; P = .03) and platelet (52.9% vs. 39.7%; P = .02) transfusions were available, and if they could continue to have regular clinic visits (36% vs. 19%; P = .0005).
“Our data suggest that rather than further educating hematologic oncologists on the value of hospice, interventions that tailor hospice services to their specific patient needs are more likely to be effective at increasing enrollment,” the researchers wrote.
“Accordingly, interventions to make additional resources available through hospice will necessitate policy changes regarding hospice reimbursement,” the researchers added. “Although there would be added costs for the provision of transfusions, there would likely be concomitant cost savings through increased hospice enrollment, which would lead to a reduction in terminal hospitalizations and/or intensive, nonefficacious treatments.” – by Alexandra Todak
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts