Early Palliative Care Consultations Are Well Received By Patients But Don’t Decrease Health Services

MedicalResearch.com Interview with:
Gabrielle Rocque MD
Division of Hematology & Oncology
University of Alabama
Birmingham, Alabama

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Rocque: This study grew out of a retrospective study we conducted in 2010 in which we evaluated the characteristics of patients admitted to our solid tumor oncology service, what occurred during their hospitalization, and what their outcomes were after discharge.  We identified that the average life expectancy of the population was less than 4 months and therefore, inpatient admission was an opportunity for palliative care support.  Therefore, we conducted a sequential, prospective cohort study of patients before and after implementation of triggered palliative care consults for patients with advanced cancer. We found that patients’ prognostic awareness meaningfully and significantly improved after the implementation of consults, but there was little impact on utilization of health services. We did identify that providing consults to the entire population of patients was logistically challenging due to short stays, high-acuity symptoms, and individual provider resistance, but overall the oncology providers found the consults to be beneficial.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Rocque: Palliative Care consultation for hospitalized cancer patients are well-received and enhance communication including an improved understanding of their cancer and their prognosis.  The oncologists also report an improved understanding of their patients’ perspective.  We recommend implementing a standardized approach to palliative care consultation.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Rocque: While hospitalization is a time of high palliative care needs, life expectancy and hospital lengths of stay are short so the impact of palliative care consultation is limited.  Given the substantial benefits of early outpatient palliative care, we suggest that future research focus on strategies for earlier integration of ambulatory palliative care services after inpatient consultation.

Citation:

J Pain Symptom Manage. 2015 Jun 15. pii: S0885-3924(15)00251-1. doi: 10.1016/j.jpainsymman.2015.04.022. [Epub ahead of print]

A Quantitative Study of Triggered Palliative Care Consultation for Hospitalized Patients with Advanced Cancer.

Rocque GB1, Campbell TC2, Johnson SK2, King J3, Zander MR4, Quale RM4, Eickhoff JC5, Cleary JF3.

Gabrielle Rocque MD, Division of Hematology & Oncology, University of Alabama, & Birmingham, Alabama (2015). Early Palliative Care Consultations Are Well Received By Patients By Don’t Decrease Health Services