A Summary of Pediatric Palliative Care Team Structure and Services as Reported by Centers Caring for Children with Cancer

Weaver, Meaghann S.; Rosenberg, Abby R.; Tager, Julia; Wichman, Christopher; Wiener, Lori

doi:10.1089/jpm.2017.0405

Cited by 77 publications

(85 citation statements)

References 18 publications

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“…A recent survey of three national list‐serves suggested three additional and important barriers to PPC integration at academic pediatric oncology centers: (1) oncologists believe they provide adequate palliative care themselves, (2) referrals to specialty PPC occur too late in the disease trajectory for patients to experience significant benefit, and (3) oncologists are unaware of the potential benefits and scope of PPC services (Fig. ) . In order to implement the PPC standard in pediatric oncology, we must overcome these barriers.…”

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confidence: 99%

“…Prior studies suggest pediatric oncologists with formal training in PPC concepts report more confidence and success in treating complex end‐of‐life symptoms . In the aforementioned survey, only one‐fifth of programs endorsed formal PPC training, suggesting a significant opportunity for improvement . At a minimum, fellows must become familiar with effective communication techniques, basic psychosocial assessment and support, and symptom assessment, including the evidence supporting each.…”

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confidence: 99%

“…Second, this education must be complemented with scholarship. Interestingly, there are ample opportunities to do so at academic pediatric hematology/oncology centers; 78% of the surveyed academic sites reported ongoing PPC research programs . Furthermore, because traditional palliative care fellowships are predominantly 1‐year clinical programs, pediatric oncologists may be well positioned to inform the science of palliative care for children with serious illnesses like cancer.…”

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confidence: 99%

“…1). 6 In order to implement the PPC standard in pediatric oncology, we must overcome these barriers. management.…”

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confidence: 99%

“…14 In the aforementioned survey, only one-fifth of programs endorsed formal PPC training, suggesting a significant opportunity for improvement. 6 At a minimum, fellows must become familiar with effective communication techniques, basic psychosocial assessment and support, and symptom assessment, including the evidence supporting each. They must also be exposed to the merits of subspecialty PPC services through clinical encounters and, potentially, formal rotations with PPC teams.…”

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confidence: 99%

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Who is responsible for delivering palliative care to children with cancer?

Rosenberg

Weaver

Wiener

2017

Pediatric Blood & Cancer

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confidence: 99%

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confidence: 99%

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confidence: 99%

“…1). 6 In order to implement the PPC standard in pediatric oncology, we must overcome these barriers. management.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Who is responsible for delivering palliative care to children with cancer?

Rosenberg

Weaver

Wiener

2017

Pediatric Blood & Cancer

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Specialty Palliative Care for Adolescents and Young Adults With Cancer—Developmental Considerations and an Agenda for Future Research

Sansom-Daly

2023

JAMA Netw Open

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Adolescents and young adults (AYA) with cancer are a group for whom the benefits of specialist palliative care may be especially profound. Freyer expressed that for the dying adolescent, "adolescence is a paradox of emerging capabilities, and diminishing possibilities." 1 For AYA, change is the one constant. In the face of potentially incurable disease, amidst all this change, palliative care can minimize AYA's suffering and maximize quality of life. 2,3 International recommendations support the integration of palliative care for young people with cancer across the care trajectory. 2 Yet, the extent to which this occurs in practice is unclear. 4 There remains inequity-and unacceptable variability-around which subgroups of AYA may ever meet palliative care and how timely this may be.To improve care, we first need to know what is already happening-and whether it helps. In their

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Evaluating palliative opportunities in pediatric patients with leukemia and lymphoma

et al. 2021

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Background Despite favorable prognoses, pediatric patients with hematologic malignancies experience significant challenges that may lead to diminished quality of life or family stress. They are less likely to receive subspecialty palliative care (PC) consultation and often undergo intensive end‐of‐life (EOL) care. We examined “palliative opportunities,” or events when the integration of PC would have the greatest impact, present during a patient's hematologic malignancy course and relevant associations. Methods A single‐center retrospective review was conducted on patients aged 0–18 years with a hematologic malignancy who died between 1/1/12 and 11/30/17. Demographic, disease, and treatment data were collected. A priori, nine palliative opportunity categories were defined. Descriptive statistics were performed. Palliative opportunities were evaluated over temporal quartiles from diagnosis to death. Timing and rationale of pediatric PC consultation were evaluated. Results Patients (n = 92) had a median of 5.0 (interquartile range [IQR] 6.0) palliative opportunities, incurring 522 total opportunities, increasing toward the EOL. Number and type of opportunities did not differ by demographics. PC consultation was most common in patients with lymphoid leukemia (50.9%, 28/55) and myeloid leukemia (48.5%, 16/33) versus lymphoma (0%, 0/4, p = 0.14). Forty‐four of ninety‐two patients (47.8%) received PC consultation a median of 1.8 months (IQR 4.1) prior to death. Receipt of PC was associated with transplant status (p = 0.0018) and a higher number of prior palliative opportunities (p = 0.0005); 70.3% (367/522) of palliative opportunities occurred without PC. Conclusion Patients with hematologic malignancies experience many opportunities warranting PC support. Identifying opportunities for ideal timing of PC involvement may benefit patients with hematologic cancers and their caregivers.

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A Summary of Pediatric Palliative Care Team Structure and Services as Reported by Centers Caring for Children with Cancer

Abstract: Children and adolescents with cancer do not yet receive concurrent palliative care as a universal standard.

Cited by 77 publications

References 18 publications

Who is responsible for delivering palliative care to children with cancer?

Who is responsible for delivering palliative care to children with cancer?

Specialty Palliative Care for Adolescents and Young Adults With Cancer—Developmental Considerations and an Agenda for Future Research

Evaluating palliative opportunities in pediatric patients with leukemia and lymphoma

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