Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Supportive Care in Cancer
Published in: Supportive Care in Cancer 2/2020

01-02-2020 | Care | Original Article

Practices and opinions of specialized palliative care physicians regarding early palliative care in oncology

Authors: Anna Sorensen, Kirsten Wentlandt, Lisa W. Le, Nadia Swami, Breffni Hannon, Gary Rodin, Monika K. Krzyzanowska, Camilla Zimmermann

Published in: Supportive Care in Cancer | Issue 2/2020

Login to get access

Abstract

Purpose

To describe the practices and opinions of specialized palliative care (SPC) physicians regarding early palliative care for patients with cancer, determine characteristics associated with receiving early referrals; and solicit opinions regarding renaming the specialty “supportive care.”

Methods

The survey was distributed by mail and e-mail to physicians who had previously self-identified as providing palliative care. SPC physicians were defined as receiving palliative care referrals from other physicians and not providing palliative care only for their own patients.

Results

The response rate was 71% (531/746), of whom 257 (48.4%) practiced SPC. Of these SPC physicians, 84% provided mainly cancer care; > 90% supported early palliative care referral in oncology and had referral criteria facilitating this, but only 20% received early referrals (> 6-month prognosis). There was ambivalence regarding caring for patients with full resuscitation status and responsibility for managing cancer treatment-related complications. SPC physicians receiving early referrals were more likely to be female (p = 0.02) and have a postgraduate degree (p = 0.02), and less likely to provide mainly cancer care (p = 0.03) and to agree that patients should stop chemotherapy before referral (p = 0.009). Although 60% agreed that patients perceive the term “palliative care” negatively and 39% believed a name change to supportive care would encourage early referral, only 21% supported renaming the specialty.

Conclusions

Although most SPC physicians supported early palliative care in oncology, the timing of referrals was often late, and was associated with characteristics of SPC physicians. Few SPC physicians supported renaming palliative care.
Literature
1.
Zimmermann C, Swami N, Krzyzanowska M et al (2014) Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. Lancet 6736:1–10
2.
Bakitas M, Lyons KD, Hegel MT, Balan S, Brokaw FC, Seville J, Hull JG, Li Z, Tosteson TD, Byock IR, Ahles TA (2009) Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the project enable II randomized controlled trial. JAMA 302:741–749CrossRef
3.
Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF, Billings JA, Lynch TJ (2010) Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 363:733–742CrossRef
4.
Vanbutsele G, Pardon K, Van Belle S et al (2018) Effect of early and systematic integration of palliative care in patients with advanced cancer: a randomised controlled trial. Lancet Oncol 19:394–404CrossRef
5.
Maltoni M, Scarpi E, Dall'Agata M, Zagonel V, Bertè R, Ferrari D, Broglia CM, Bortolussi R, Trentin L, Valgiusti M, Pini S, Farolfi A, Casadei Gardini A, Nanni O, Amadori D, Frassineti GL, Sansoni E, Ragazzini A, Ruscelli S, Crivellari G, Galiano A, Rodriquenz MG, Biasini C, Porzio R, Pittureri C, Amaducci E, Faedi M, Codecà C, Crepaldi F, Pedrazzoli P, Bramanti A, Buonadonna A, Garetto F, Comandone A, Giordano M, Luchena G, Luzzani M, Cifatte C, Pino MS, Zoccali S, Cattaneo MT, Dalu D, Sozzi P, Gauna R, Alquati S, Costantini M, Quadrini S, Narducci F, Mastromauro C, Scognamiglio R, Degiovanni D, Negri F, Caraceni A, Montanari L (2016) Systematic versus on-demand early palliative care: results from a multicentre, randomised clinical trial. Eur J Cancer 65:61–68CrossRef
6.
Kavalieratos D, Corbelli J, Zhang D, Dionne-Odom JN, Ernecoff NC, Hanmer J, Hoydich ZP, Ikejiani DZ, Klein-Fedyshin M, Zimmermann C, Morton SC, Arnold RM, Heller L, Schenker Y (2016) Association between palliative care and patient and caregiver outcomes: a systematic review and meta-analysis. JAMA 316:2104–2114CrossRef
7.
Gaertner J, Siemens W, Meerpohl JJ et al (2017) Effect of specialist palliative care services on quality of life in adults with advanced incurable illness in hospital, hospice, or community settings: systematic review and meta-analysis. BMJ 357:j2925CrossRef
8.
9.
Cherny N, Catane R, Schrijvers D, Kloke M, Strasser F (2010) European Society for Medical Oncology (ESMO) program for the integration of oncology and palliative care: a 5-year review of the designated centers’ incentive program. Ann Oncol 21:362–369CrossRef
10.
Ferrell BR, Temel JS, Temin S, Alesi ER, Balboni TA, Basch EM, Firn JI, Paice JA, Peppercorn JM, Phillips T, Stovall EL, Zimmermann C, Smith TJ (2017) Integration of palliative care into standard oncology care: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 35:96–112CrossRef
11.
Wentlandt K, Krzyzanowska MK, Swami N, Rodin GM, le LW, Zimmermann C (2012) Referral practices of oncologists to specialized palliative care. J Clin Oncol 30:4380–4386CrossRef
12.
Charalambous H, Pallis A, Hasan B, O’Brien M (2014) Attitudes and referral patterns of lung cancer specialists in Europe to specialized palliative care (SPC) and the practice of early palliative care (EPC). BMC Palliat Care 13:59CrossRef
13.
Johnson CE, Girgis A, Paul CL, Currow DC (2008) Cancer specialists’ palliative care referral practices and perceptions: results of a national survey. Palliat Med 22:51–57CrossRef
14.
Ward AM, Agar M, Koczwara B (2009) Collaborating or co-existing: a survey of attitudes of medical oncologists toward specialist palliative care. Palliat Med 23:698–707CrossRef
15.
Smith CB, Nelson JE, Berman AR, Powell CA, Fleischman J, Salazar-Schicchi J, Wisnivesky JP (2012) Lung cancer physicians’ referral practices for palliative care consultation. Ann Oncol 23:382–387CrossRef
16.
Schenker Y, Crowley-Matoka M, Dohan D, Rabow MW, Smith CB, White DB, Chu E, Tiver GA, Einhorn S, Arnold RM (2014) Oncologist factors that influence referrals to subspecialty palliative care clinics. J Oncol Pract 10:e37–e44CrossRef
17.
Rhondali W, Burt S, Wittenberg-Lyles E, Bruera E, Dalal S (2013) Medical oncologists’ perception of palliative care programs and the impact of name change to supportive care on communication with patients during the referral process. A qualitative study. Palliat Support Care 11:397–404CrossRef
18.
Zimmermann C, Swami N, Krzyanowska M et al (2016) Perceptions of palliative care among patients with advanced cancer and their caregivers. CMAJ 188(10):E217–E227CrossRef
19.
Miyashita M, Hirai K, Morita T, Sanjo M, Uchitomi Y (2008) Barriers to referral to inpatient palliative care units in Japan: a qualitative survey with content analysis. Support Care Cancer 16:217–222CrossRef
20.
Morstad Boldt A, Yusuf F, Himelstein BP (2006) Perceptions of the term palliative care. J Palliat Med 9:1128–1136CrossRef
21.
Fadul N, Elsayem A, Palmer JL, del Fabbro E, Swint K, Li Z, Poulter V, Bruera E (2009) Supportive versus palliative care: what’s in a name? Cancer 115:2013–2021CrossRef
22.
Dalal S, Palla S, Hui D, Nguyen L, Chacko R, Li Z, Fadul N, Scott C, Thornton V, Coldman B, Amin Y, Bruera E (2011) Association between a name change from palliative to supportive care and the timing of patient referrals at a comprehensive cancer center. Oncologist 16:105–111CrossRef
23.
Maciasz RM, Arnold R, Chu E et al (2013) Does it matter what you call it? A randomized trail of language used to describe palliative care services. Support Cancer Care 21:1–16CrossRef
24.
Johnson C, Girgis A, Paul C, Currow DC, Adams J, Aranda S (2011) Australian palliative care providers’ perceptions and experiences of the barriers and facilitators to palliative care provision. Support Care Cancer 19:343–351CrossRef
25.
26.
27.
28.
29.
Hui D, Finlay E, Buss MK, Prommer EE, Bruera E (2015) Palliative oncologists: specialists in the science and art of patient care. J Clin Oncol 33:2314–2317CrossRef
30.
Hui D, Bansal S, Strasser F, Morita T, Caraceni A, Davis M, Cherny N, Kaasa S, Currow D, Abernethy A, Nekolaichuk C, Bruera E (2015) Indicators of integration of oncology and palliative care programs: an international consensus. Ann Oncol 26:1953–1959CrossRef
31.
Kaasa S, Loge JH, Aapro M, Albreht T, Anderson R, Bruera E, Brunelli C, Caraceni A, Cervantes A, Currow DC, Deliens L, Fallon M, Gómez-Batiste X, Grotmol KS, Hannon B, Haugen DF, Higginson IJ, Hjermstad MJ, Hui D, Jordan K, Kurita GP, Larkin PJ, Miccinesi G, Nauck F, Pribakovic R, Rodin G, Sjøgren P, Stone P, Zimmermann C, Lundeby T (2018) Integration of oncology and palliative care: a lancet oncology commission. Lancet Oncol 19(11):e588–e653CrossRef
32.
Von Roenn JH, Voltz R, Serrie A (2013) Barriers and approaches to the successful integration of palliative care and oncology practice. J Natl Compr Cancer Netw 11:S12–S16
33.
Kellerman SE, Herold J (2001) Physician response to surveys. Am J Prev Med 20:61–67CrossRef
34.
35.
36.
Metadata
Title
Practices and opinions of specialized palliative care physicians regarding early palliative care in oncology
Authors
Anna Sorensen
Kirsten Wentlandt
Lisa W. Le
Nadia Swami
Breffni Hannon
Gary Rodin
Monika K. Krzyzanowska
Camilla Zimmermann
Publication date
01-02-2020
Publisher
Springer Berlin Heidelberg
Keyword
Care
Published in
Supportive Care in Cancer / Issue 2/2020
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-019-04876-0

Other articles of this Issue 2/2020

Supportive Care in Cancer 2/2020 Go to the issue

Original Article

Differences in the health, mental health and health-promoting behaviours of rural versus urban cancer survivors in Australia

Original Article

Long-term sleep disturbance and prescription sleep aid use among cancer survivors in the United States

Original Article

Factors influencing return to work of cancer survivors: a population-based study in Italy

Original Article

Primary care physicians’ perspectives of the survivorship care for older breast cancer survivors: a pilot study

Original Article

Usefulness of Kinect sensor–based reachable workspace system for assessing upper extremity dysfunction in breast cancer patients

Original Article

Development process of an evidence-based exercise program for post-operative colorectal cancer patients
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits