Perceptions Of Barriers To High-Quality Palliative Care In Hospitals

Cassel, Christine K.; Ludden, John M.; Moon, Grace M.

doi:10.1377/hlthaff.19.5.166

Cited by 24 publications

(11 citation statements)

References 6 publications

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“…Thus, much work remains to be done to bring palliative care earlier in the disease trajectory, ideally before the Phase I visit. Studies from our group and others have demonstrated that palliative care referral is dependent on various factors, including oncologists’ perception and attitudes,21,32 patient characteristics and preferences33,34 and healthcare infrastructure and policies 35. Consistent with the literature,36 we found that cancer diagnosis, which dictates which team of oncologists the patient sees, is a key determinant on the timing of referral to palliative care.…”

Section: Discussionsupporting

confidence: 85%

Timing of palliative care referral and symptom burden in phase 1 cancer patients

Hui

Parsons

Nguyen

et al. 2010

Cancer

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Background Phase I trials offer advanced cancer patients the opportunity to pursue life-prolonging cancer treatments. In this study, we compared the timing of referral and symptom burden between patients referred to palliative care by Phase I oncologists and those referred by non-Phase I oncologists. Methods All 57 patients with advanced solid tumors referred by Phase I to our palliative care outpatient clinic in 2007/2008 were included. The comparison cohort consisted of 114 non-Phase I patients stratified by age, sex and cancer diagnosis in a 1:2 ratio. We retrieved information regarding patient characteristics, Edmonton Symptom Assessment Scale (ESAS), timing of referral and survival. Results Both cohorts had the following matched characteristics: average age 57, female 44% and gastrointestinal cancers 47%. At the time of palliative care consultation, Phase I patients were more likely than non-Phase I patients to have a better performance status (ECOG 0-1, 61% vs. 36%, P=0.003). ESAS was not different except for better well-being in the Phase I cohort (mean 4.5 vs. 5.5, p=0.03). No difference was found for the duration between M.D. Anderson registration and palliative care consult (13 vs. 11 months, P=0.41) and overall survival from time of palliative care consult (5 vs. 4 months, P=0.69). Conclusions Phase I outpatients referred to palliative care had a better performance status but similar symptom burden as non-Phase I patients. Phase I involvement did not delay palliative care referral compared to non-Phase I. This supports the development of a simultaneous care model.

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Section: Discussionsupporting

confidence: 85%

Timing of palliative care referral and symptom burden in phase 1 cancer patients

Hui

Parsons

Nguyen

et al. 2010

Cancer

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show abstract

“…Thus, much work remains to be done to provide palliative care earlier in the disease trajectory, ideally before the phase 1 oncologist visit. Studies from our group and others have demonstrated that palliative care referral is dependent on various factors, including the oncologist's perception and attitudes,21, 32 patient characteristics and preferences,33, 34 and healthcare infrastructure and policies 35. Consistent with the literature,36 we found that a cancer diagnosis, which dictates which team of oncologists the patient sees, is a key determinant regarding the timing of referral to palliative care.…”

Section: Discussionsupporting

confidence: 84%

Emergence of potential biomarkers of response to anti‐angiogenic anti‐tumour agents

Michael

Relph

Pandha

2010

Intl Journal of Cancer

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Anti-angiogenic agents targeting tumour vasculature have an established place in clinical practice, and new data are constantly emerging. However, despite rapid clinical uptake, a very large number of questions regarding these agents remain unanswered. One of the main hurdles in clinical practice is lack of accurate and feasible ways of assessing response to drug beyond tumour reduction on conventional imaging. This review summarises recent developments in the field of biomarkers of response to anti-VEGF drugs.

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“…Interviews mit krebskranken und herzinsuffizienten Patienten verdeutlichen, dass letztere im Vergleich zu Krebskranken noch weniger über ihre Situation und über Angebote von Palliative Care Teams informiert werden[26].Cassel et al[27] sprechen auf dem Boden von Experteninterviews davon, dass die der amerikanischen Kultur zuzurechnende Weigerung der Auseinandersetzung mit dem Tod ein bedeutendes nicht-ökonomisches Hindernis für die Entwicklung angemessener palliativer Versorgungskonzepte sei, auch wenn ökonomische Aspekte nicht zu vernachlässigen seien, da mit aggressiver Therapie mehr Geld zu verdienen sei als mit Palliation. -Ein Statement der American Society of Clinical Oncology (ASCO) aus dem Jahr 2011[28] geht davon aus, dass weniger als 40 Prozent von Patientinnen und Patienten mit fortgeschrittenem Krebsleiden die ihnen zustehende Aufklärung und Beratung erhalten.…”

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Palliativmedizin: Ein Modell für Comparative Effectiveness Research?

Schmacke

2012

Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheit

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Perceptions Of Barriers To High-Quality Palliative Care In Hospitals

Cited by 24 publications

References 6 publications

Timing of palliative care referral and symptom burden in phase 1 cancer patients

Timing of palliative care referral and symptom burden in phase 1 cancer patients

Emergence of potential biomarkers of response to anti‐angiogenic anti‐tumour agents

Palliativmedizin: Ein Modell für Comparative Effectiveness Research?

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