PURPOSE: Hospice services are designed to meet the needs of patients near the end of life. Although so-called open-access hospice programs and bridge programs are beginning to offer these services to patients who are still receiving treatment, it is not known whether they best meet patients' needs. PATIENTS AND METHODS: Three hundred adult patients receiving treatment for cancer completed interviews in which each patient's value or ability for supportive care services were calculated from the choices that they made among combinations of those services. Preferences for five traditional hospice services and six alternative supportive care services were measured, and patients were followed up for 6 months or until death. RESULTS: Patients' utilities for alternative services were higher than those for traditional hospice services (0.53 v 0.39; sign-rank test P < .001). Alternative services were also preferred among patients with poor functional status (Eastern Cooperative Oncology Group performance score > 2; n = 54; 0.65 v 0.48; P < .001) and among those who were in the last 6 months of life (0.68 v 0.56; sign-rank test P = .003). Even patients who were willing to forgo cancer treatment (n = 38; 13%) preferred alternative services (3.1 v 1.8; P < .001). CONCLUSION: Patients who are receiving active treatment for cancer, and even those who are willing to stop treatment, express a clear preference for alternative supportive care services over traditional hospice services. Supportive care programs for patients with advanced cancer should reconsider the services that they offer and might seek to include novel services in addition to, or perhaps instead of, traditional hospice services.
PURPOSE: Hospice services are designed to meet the needs of patients near the end of life. Although so-called open-access hospice programs and bridge programs are beginning to offer these services to patients who are still receiving treatment, it is not known whether they best meet patients' needs. PATIENTS AND METHODS: Three hundred adult patients receiving treatment for cancer completed interviews in which each patient's value or ability for supportive care services were calculated from the choices that they made among combinations of those services. Preferences for five traditional hospice services and six alternative supportive care services were measured, and patients were followed up for 6 months or until death. RESULTS:Patients' utilities for alternative services were higher than those for traditional hospice services (0.53 v 0.39; sign-rank test P < .001). Alternative services were also preferred among patients with poor functional status (Eastern Cooperative Oncology Group performance score > 2; n = 54; 0.65 v 0.48; P < .001) and among those who were in the last 6 months of life (0.68 v 0.56; sign-rank test P = .003). Even patients who were willing to forgo cancer treatment (n = 38; 13%) preferred alternative services (3.1 v 1.8; P < .001). CONCLUSION:Patients who are receiving active treatment for cancer, and even those who are willing to stop treatment, express a clear preference for alternative supportive care services over traditional hospice services. Supportive care programs for patients with advanced cancer should reconsider the services that they offer and might seek to include novel services in addition to, or perhaps instead of, traditional hospice services.
Authors: Karen E Steinhauser; Robert M Arnold; Maren K Olsen; Jennifer Lindquist; Judith Hays; Laura L Wood; Allison M Burton; James A Tulsky Journal: J Pain Symptom Manage Date: 2011-01-28 Impact factor: 3.612
Authors: Hans F Stabenau; Laura J Morrison; Evelyne A Gahbauer; Linda Leo-Summers; Heather G Allore; Thomas M Gill Journal: Ann Fam Med Date: 2015 Jan-Feb Impact factor: 5.166
Authors: Ben Y Durkee; Yushen Qian; Erqi L Pollom; Martin T King; Sara A Dudley; Jenny L Shaffer; Daniel T Chang; Iris C Gibbs; Jeremy D Goldhaber-Fiebert; Kathleen C Horst Journal: J Clin Oncol Date: 2015-09-08 Impact factor: 44.544