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Access To Palliative Care Among Patients Treated At A Comprehensive Cancer Center.

D. Hui, Sun-Hyun Kim, J. Kwon, K. Tanco, Tao Zhang, J. H. Kang, W. Rhondali, G. Chisholm, E. Bruera
Published 2012 · Medicine

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BACKGROUND Palliative care (PC) is a critical component of comprehensive cancer care. Previous studies on PC access have mostly examined the timing of PC referral. The proportion of patients who actually receive PC is unclear. We determined the proportion of cancer patients who received PC at our comprehensive cancer center and the predictors of PC referral. METHODS We reviewed the charts of consecutive patients with advanced cancer from the Houston region seen at MD Anderson Cancer Center who died between September 2009 and February 2010. We compared patients who received PC services with those who did not receive PC services before death. RESULTS In total, 366 of 816 (45%) decedents had a PC consultation. The median interval between PC consultation and death was 1.4 months (interquartile range, 0.5-4.2 months) and the median number of medical team encounters before PC was 20 (interquartile range, 6-45). On multivariate analysis, older age, being married, and specific cancer types (gynecologic, lung, and head and neck) were significantly associated with a PC referral. Patients with hematologic malignancies had significantly fewer PC referrals (33%), the longest interval between an advanced cancer diagnosis and PC consultation (median, 16 months), the shortest interval between PC consultation and death (median, 0.4 months), and one of the largest numbers of medical team encounters (median, 38) before PC. CONCLUSIONS We found that a majority of cancer patients at our cancer center did not access PC before they died. PC referral occurs late in the disease process with many missed opportunities for referral.
This paper references
10.1191/0269216304pm873oa
Specialist palliative care needs of whole populations: a feasibility study using a novel approach
D. Currow (2004)
10.1097/01.mlr.0000108765.86294.1b
Decreasing Variation in the Use of Hospice Among Older Adults With Breast, Colorectal, Lung, and Prostate Cancer
N. Lackan (2004)
「緩和ケア」として行われた介入と副次的評価項目であることの限界 (論文を読み,理解する--Early palliative care for patients with metastatic non-small-cell lung cancer)
森田 達也 (2011)
10.1001/archinte.168.16.1783
Cost savings associated with US hospital palliative care consultation programs.
R. Morrison (2008)
10.1200/JCO.2010.29.5618
Integrating supportive and palliative care in the trajectory of cancer: establishing goals and models of care.
E. Bruera (2010)
10.1002/cncr.24206
Supportive versus palliative care: What's in a name?
N. Fadul (2009)
10.1200/JCO.2011.38.5161
American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care.
T. Smith (2012)
10.1016/S0885-3924(02)00688-7
Effectiveness of palliative day care in improving pain, symptom control, and quality of life.
D. Goodwin (2003)
10.1188/02.ONF.1421-1428
Symptom distress and quality of life in patients with cancer newly admitted to hospice home care.
S. McMillan (2002)
10.1016/J.JPAINSYMMAN.2003.10.011
Impact of a half-day multidisciplinary symptom control and palliative care outpatient clinic in a comprehensive cancer center on recommendations, symptom intensity, and patient satisfaction: a retrospective descriptive study.
F. Strasser (2004)
10.1089/jpm.2007.0103
Interval between first palliative care consult and death in patients diagnosed with advanced cancer at a comprehensive cancer center.
B. Osta (2008)
10.1002/cncr.25389
Timing of palliative care referral and symptom burden in phase 1 cancer patients
D. Hui (2010)
10.1634/theoncologist.2010-0161
Association between a name change from palliative to supportive care and the timing of patient referrals at a comprehensive cancer center.
S. Dalal (2011)
10.1016/S0885-3924(99)00084-6
Terminal cancer patients and timing of referral to palliative care: a multicenter prospective cohort study. Italian Cooperative Research Group on Palliative Medicine.
M. Costantini (1999)
10.1191/0269216304pm921oa
Systematic review of the problems and issues of accessing specialist palliative care by patients, carers and health and social care professionals
N. Ahmed (2004)
10.1002/cncr.24017
Symptom distress, interventions, and outcomes of intensive care unit cancer patients referred to a palliative care consult team
M. Delgado-Guay (2009)
10.1001/JAMA.279.23.1877
Management of pain in elderly patients with cancer. SAGE Study Group. Systematic Assessment of Geriatric Drug Use via Epidemiology.
R. Bernabei (1998)
10.1097/MLR.0b013e31817d931d
A Population-based Study of Age Inequalities in Access to Palliative Care Among Cancer Patients
F. Burge (2008)
10.1200/JCO.2010.30.7173
Trajectory of performance status and symptom scores for patients with cancer during the last six months of life.
H. Seow (2011)
10.1016/J.JPAINSYMMAN.2005.06.007
A comparison of symptom prevalence in far advanced cancer, AIDS, heart disease, chronic obstructive pulmonary disease and renal disease.
J. P. Solano (2006)
10.1200/jco.1998.16.5.1986
Cancer care during the last phase of life.
D. S. Gordon (1998)
10.1089/JPM.2006.0259
Predictors of access to palliative care services among patients who died at a Comprehensive Cancer Center.
N. Fadul (2007)
10.1191/0269216306pm1146oa
Who receives specialist palliative care in Western Australia - and who misses out
L. Rosenwax (2006)
10.1089/JPM.2006.0257
Characteristics, findings, and outcomes of palliative care inpatient consultations at a comprehensive cancer center.
F. Braiteh (2007)
10.1089/JPM.2005.8.1025
Interval between palliative care referral and death among patients treated at a comprehensive cancer center.
W. Cheng (2005)
10.1002/cncr.24942
Antineoplastic therapy use in patients with advanced cancer admitted to an acute palliative care unit at a comprehensive cancer center
D. Hui (2010)
Facts and Figures on Hospice
N Fadul (2011)
10.1089/JPM.2006.9.894
Impact of a palliative care service on in-hospital mortality in a comprehensive cancer center.
A. Elsayem (2006)
10.1046/j.1365-2389.2003.51310.x
Hospice Usage by Minorities in the Last Year of Life: Results from the National Mortality Followback Survey
K. A. Greiner (2003)
10.1200/JCO.2007.15.4864
Predictors of referral for specialized psychosocial oncology care in patients with metastatic cancer: the contributions of age, distress, and marital status.
J. Ellis (2009)
10.1001/jama.2010.258
Availability and integration of palliative care at US cancer centers.
D. Hui (2010)
10.1016/j.jpainsymman.2010.03.017
Impact of a palliative care consultation team on cancer-related symptoms in advanced cancer patients referred to an outpatient supportive care clinic.
S. Yennurajalingam (2011)
10.1200/JCO.2004.11.003
Palliative care inpatient service in a comprehensive cancer center: clinical and financial outcomes.
A. Elsayem (2004)
10.1200/JCO.2008.20.1558
Palliative cancer care a decade later: accomplishments, the need, next steps -- from the American Society of Clinical Oncology.
F. Ferris (2009)
10.1371/journal.pbio.0040077
When Seeing Is Misleading: Clutter Leads to High-Confidence Errors
L. Gross (2006)
10.1007/s005200050281
The symptoms of advanced cancer: relationship to age, gender, and performance status in 1,000 patients
D. Walsh (2000)
10.1002/pon.1918
Cancer Care Ontario's experience with implementation of routine physical and psychological symptom distress screening
D. Dudgeon (2012)
10.1016/J.JPAINSYMMAN.2005.04.007
Impact of palliative care unit admission on symptom control evaluated by the edmonton symptom assessment system.
C. Modonesi (2005)



This paper is referenced by
10.1177/0269216317735246
Palliative care in patients with haematological neoplasms: An integrative systematic review
Deborah Moreno-Alonso (2018)
10.3346/jkms.2018.33.e263
Factors Related with Utilizing Hospice Palliative Care Unit among Terminal Cancer Patients in Korea between 2010 and 2014: a Single Institution Study
S. Park (2018)
10.1002/cncr.28628
Impact of timing and setting of palliative care referral on quality of end‐of‐life care in cancer patients
D. Hui (2014)
10.1634/theoncologist.2019-0384
Frequency, Timing and Predictors of Palliative Care Consultation in Patients with Advanced Cancer at a Tertiary Cancer Center: Secondary Analysis of Routinely Collected Health Data.
SharonM Watanabe (2020)
10.1007/978-3-319-77740-5_42
Generalist and Specialist Palliative Care
K. Ryan (2019)
10.1200/JOP.2015.006619
ReCAP: Attitudes, Beliefs, and Awareness of Graduate Medical Education Trainees Regarding Palliative Care at a Comprehensive Cancer Center.
A. Wong (2016)
10.6004/JNCCN.2016.0009
Palliative Care Version 1.2016.
Michael Levy (2016)
10.1001/jamaoncol.2015.5321
The Emergency Department Point of Palliative Care Access for Patients With Advanced Cancer.
E. Bruera (2016)
10.1200/JOP.18.00346
1-2-3 Project: A Quality Improvement Initiative to Normalize and Systematize Palliative Care for All Patients With Cancer in the Outpatient Clinic Setting.
Anjali V. Desai (2018)
10.1016/j.ejon.2014.01.003
"There won't' be anything else...it's over": perceptions of women referred to palliative care only.
F. C. Rugno (2014)
10.1136/bmjspcare-2015-000997
Characteristics of the case mix, organisation and delivery in cancer palliative care: a challenge for good-quality research
M. Hjermstad (2016)
10.1200/JCO.2013.52.4330
Identification of potentially avoidable hospitalizations in patients with GI cancer.
G. Brooks (2014)
10.1136/ijgc-2019-000430
Persistent opioid use after radiation therapy in opioid-naive cervical cancer survivors
Kelsey E Ward (2019)
10.1111/jocn.14618
Managing clinical uncertainty: An ethnographic study of the impact of critical care outreach on end‐of‐life transitions in ward‐based critically ill patients with a life‐limiting illness
N. Pattison (2018)
10.3322/caac.21192
Early integration of palliative care services with standard oncology care for patients with advanced cancer
J. Greer (2013)
10.1016/j.jpainsymman.2019.04.027
Patients Perspective of Timeliness and Usefulness of an Outpatient Supportive Care Referral at a Comprehensive Cancer Center.
A. Wong (2019)
10.15406/HPMIJ.2018.02.00048
Palliative Care Utilization in Patients with Newly Diagnosed, Incurable Solid Tumor Malignancies: Experience of an Institution New to Palliative Care
Josh Romain (2018)
10.1136/bmjspcare-2012-000360
Barriers to research in palliative care in France
W. Rhondali (2013)
10.1080/09699260.2016.1186342
Dyspnea—Can we do more? A view from a tertiary hospital palliative care service
Shirlyn Hui Shan Neo (2016)
10.1136/bmjspcare-2020-002195
Palliative versus hospice care in patients with cancer: a systematic review
M. Frasca (2020)
10.1038/s41416-018-0070-5
End-of-life decision-making across cancer types: results from a nationwide retrospective survey among treating physicians
M. Verkissen (2018)
10.1177/0269216320963892
The palliative care needs and experiences of people with advanced head and neck cancer: A scoping review.
C. Mayland (2020)
10.1136/bmjopen-2016-012576
What determines duration of palliative care before death for patients with advanced disease? A retrospective cohort study of community and hospital palliative care provision in a large UK city
M. Bennett (2016)
10.1097/MCP.0b013e3283620e76
Integrating palliative care: when and how?
J. Shin (2013)
10.1111/bju.14708
Palliative care use amongst patients with bladder cancer
Lee A Hugar (2019)
10.28971/532019hj118
Integration of Early Palliative Care in Oncology Patients: Improving Nursing Knowledge and Confidence
Jacqueline Hurteau (2019)
10.1186/s12885-017-3560-6
The feasibility and benefit of a brief psychosocial intervention in addition to early palliative care in patients with advanced cancer to reduce depressive symptoms: a pilot randomized controlled clinical trial
Thamires Monteiro do Carmo (2017)
10.1200/JCO.2014.58.7824
Benefits of Early Versus Delayed Palliative Care to Informal Family Caregivers of Patients With Advanced Cancer: Outcomes From the ENABLE III Randomized Controlled Trial.
J. Dionne-Odom (2015)
10.17226/18359
Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis
L. Levit (2014)
10.1007/s11912-019-0804-4
Management of Newly Diagnosed Elderly Multiple Myeloma Patients
Crystal Antoine-Pepeljugoski (2019)
10.1007/s00520-017-3922-2
Palliative care content on cancer center websites
L. Vater (2017)
CLEP_A_198499 443..455
A. Janah (2019)
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