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01.03.2023 | Research

Palliative care use and utilization determinants among patients treated for advanced stage lung cancer care in the community and academic medical setting

verfasst von: Laurie E. McLouth, Tia Borger, Vilma Bursac, Michael Hoerger, Jessica McFarlin, Shaylla Shelton, Brent Shelton, Andrew Shearer, Marc T. Kiviniemi, Jerod L. Stapleton, Timothy Mullett, Jamie L. Studts, David Goebel, Ravneet Thind, Laura Trice, Nancy E. Schoenberg

Erschienen in: Supportive Care in Cancer | Ausgabe 3/2023

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Abstract

Purpose

Despite clinical guidelines, palliative care is underutilized during advanced stage lung cancer treatment. To inform interventions to increase its use, patient-level barriers and facilitators (i.e., determinants) need to be characterized, especially among patients living in rural areas or those receiving treatment outside academic medical centers.

Methods

Between 2020 and 2021, advanced stage lung cancer patients (n = 77; 62% rural; 58% receiving care in the community) completed a one-time survey assessing palliative care use and its determinants. Univariate and bivariate analyses described palliative care use and determinants and compared scores by patient demographic (e.g., rural vs. urban) and treatment setting (e.g., community vs. academic medical center) factors.

Results

Roughly half said they had never met with a palliative care doctor (49.4%) or nurse (58.4%) as part of cancer care. Only 18% said they knew what palliative care was and could explain it; 17% thought it was the same as hospice. After palliative care was distinguished from hospice, the most frequently cited reasons patients stated they would not seek palliative care were uncertainty about what it would offer (65%), concerns about insurance coverage (63%), difficulty attending multiple appointments (60%), and lack of discussion with an oncologist (59%). The most common reasons patients stated they would seek palliative care were a desire to control pain (62%), oncologist recommendation (58%), and coping support for family and friends (55%).

Conclusion

Interventions should address knowledge and misconceptions, assess care needs, and facilitate communication between patients and oncologists about palliative care.

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Titel: Palliative care use and utilization determinants among patients treated for advanced stage lung cancer care in the community and academic medical setting
verfasst von: Laurie E. McLouth
Tia Borger
Vilma Bursac
Michael Hoerger
Jessica McFarlin
Shaylla Shelton
Brent Shelton
Andrew Shearer
Marc T. Kiviniemi
Jerod L. Stapleton
Timothy Mullett
Jamie L. Studts
David Goebel
Ravneet Thind
Laura Trice
Nancy E. Schoenberg
Publikationsdatum: 01.03.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 3/2023
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-023-07649-y

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Palliative care use and utilization determinants among patients treated for advanced stage lung cancer care in the community and academic medical setting