MedicalResearch.com Interview with: Joshua R. Lakin, MD Assistant Professor of Medicine Harvard Medical School Dana Farber Cancer Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: Research has increasingly shown the benefits of early palliative care interventions, especially in those around communication about patient goals and preferences in serious illness. These benefits include improved quality of life and psychological outcomes for patients as well as eased bereavement and decision making for loved ones. We have a large gap to fill in initiating early goals and values conversations with our patients and there are a myriad of systems failures and clinician barriers that do not allow us to do this work in a timely and effective way. Doing so with limited resources, both in specialty palliative care and in the many frontline clinicians doing this work, requires targeting our resources carefully. Doing these conversations earlier means identifying patients upstream, before they are in the last days of life. The Surprise Question – “Would you be surprised if this patient died in the next year?” – has emerged as an attractive option for screening for early palliative care interventions. It has been studied primarily in dialysis and cancer patients and has been demonstrated to have a strong association with risk of death. We set out to test it in a more diverse primary care population. (more…)