Multidisciplinary tumor board for improvement of oncology collaboration in advanced cancer patients.

Chang, Sanders; Doshi, Amish; Smith, Cardinale B.; Scarborough, Bethann; Serban, Stelian; Ciccone, Jeffrey; Dharmarajan, Kavita V.

doi:10.1200/jco.2016.34.26_suppl.175

Cited by 5 publications

(1 citation statement)

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“…This study highlights a critical opportunity for improved collaboration amongst oncologists (medical, surgical, radiation) and palliative care physicians, which may aid individual team members to feel autonomous in counseling patients regarding end-of-life care. Potential interventions to improve this collaboration could include a “tumor board” setting where multidisciplinary providers and supportive oncology (i.e., nutrition, social work, psychologist) could discuss complex patients care plans ( 21 ) ensuring providers are “on the same page” for patient prognosis and care plan. Addressing these barriers to early palliative care integration may significantly decrease health care expenditures, as has been suggested by studies examining the timing of palliative care ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

Medical oncologist perspectives on palliative care reveal physician-centered barriers to early integration

Kruser

Gross

et al. 2020

Ann Palliat Med

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Background: Early palliative care referral for patients with advanced cancer has demonstrable benefits but is underutilized. We sought to characterize medical oncologists’ perceptions about palliative care referral in their clinical practices. Methods: We conducted 4 focus groups with a national sample of medical oncologists to elicit perspectives about the optimal timing of and barriers to palliative care referral for patients with cancer. We used qualitative content analysis to uncover themes related to early integration of palliative care into standard oncologic practice. Results: Study participants readily acknowledged the evidence supporting early palliative care referral. However, medical oncologists identified patient-centered and physician-centered barriers to widespread adoption of early palliative care. Patient-centered barriers included patients’ and families’ perceptions or misperceptions of the role of palliative care. Additionally, physicians themselves described acting as a barrier to palliative care referral because they were concerned that palliative care physicians may interfere with the plan of care, or offer options that were not endorsed by the medical oncologist. Medical oncologists depicted themselves having authority over the timing of palliative care referral, and as granting limited autonomy to other clinical team members in counseling patients about advanced care planning. Conclusions: Medical oncologists are hesitant to adopt the practice of early palliative care referral because they are concerned that other physicians may disrupt a patient’s treatment plan. Physician-centered barriers may delay integration of palliative care, and future efforts to promote a collaborative approach to advanced care planning may improve patient-centered outcomes through access to early palliative care.

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Section: Discussionmentioning

confidence: 99%