OBJECTIVE: The purpose of this study was to understand oncology clinicians' perspectives about the care of advanced cancer patients following the completion of the ENABLE II (Educate, Nurture, Advise, Before Life Ends) randomized clinical trial (RCT) of a concurrent oncology palliative care model. METHOD: This was a qualitative interview study of 35 oncology clinicians about their approach to patients with advanced cancer and the effect of the ENABLE II RCT. RESULTS: Oncologists believed that integrating palliative care at the time of an advanced cancer diagnosis enhanced patient care and complemented their practice. Self-assessment of their practice with advanced cancer patients comprised four themes: (1) treating the whole patient, (2) focusing on quality versus quantity of life, (3) “some patients just want to fight,” and (4) helping with transitions; timing is everything. Five themes comprised oncologists' views on the complementary role of palliative care: (1) “refer early and often,” (2) referral challenges: “Palliative” equals “hospice”; “Heme patients are different,” (3) palliative care as consultants or co-managers, (4) palliative care “shares the load,” and (5) ENABLE II facilitated palliative care integration. SIGNIFICANCE OF RESULTS: Oncologists described the RCT as holistic and complementary, and as a significant factor in adopting concurrent care as a standard of care.
OBJECTIVE: The purpose of this study was to understand oncology clinicians' perspectives about the care of advanced cancer patients following the completion of the ENABLE II (Educate, Nurture, Advise, Before Life Ends) randomized clinical trial (RCT) of a concurrent oncology palliative care model. METHOD: This was a qualitative interview study of 35 oncology clinicians about their approach to patients with advanced cancer and the effect of the ENABLE II RCT. RESULTS: Oncologists believed that integrating palliative care at the time of an advanced cancer diagnosis enhanced patient care and complemented their practice. Self-assessment of their practice with advanced cancer patients comprised four themes: (1) treating the whole patient, (2) focusing on quality versus quantity of life, (3) “some patients just want to fight,” and (4) helping with transitions; timing is everything. Five themes comprised oncologists' views on the complementary role of palliative care: (1) “refer early and often,” (2) referral challenges: “Palliative” equals “hospice”; “Heme patients are different,” (3) palliative care as consultants or co-managers, (4) palliative care “shares the load,” and (5) ENABLE II facilitated palliative care integration. SIGNIFICANCE OF RESULTS: Oncologists described the RCT as holistic and complementary, and as a significant factor in adopting concurrent care as a standard of care.
Authors: Jennifer S Temel; Joseph A Greer; Alona Muzikansky; Emily R Gallagher; Sonal Admane; Vicki A Jackson; Constance M Dahlin; Craig D Blinderman; Juliet Jacobsen; William F Pirl; J Andrew Billings; Thomas J Lynch Journal: N Engl J Med Date: 2010-08-19 Impact factor: 91.245
Authors: Keri L Rodriguez; Frank J Gambino; Phyllis Butow; Rebecca Hagerty; Robert M Arnold Journal: Support Care Cancer Date: 2006-09-13 Impact factor: 3.603
Authors: Vicki A Jackson; Jennifer Mack; Robin Matsuyama; Mathew D Lakoma; Amy M Sullivan; Robert M Arnold; Jane C Weeks; Susan D Block Journal: J Palliat Med Date: 2008-07 Impact factor: 2.947
Authors: Julia E Szymczak; Theodore Schall; Douglas L Hill; Jennifer K Walter; Shefali Parikh; Concetta DiDomenico; Chris Feudtner Journal: J Pain Symptom Manage Date: 2018-02-07 Impact factor: 3.612
Authors: Mitra Tewes; Teresa Rettler; Nathalie Wolf; Jörg Hense; Martin Schuler; Martin Teufel; Mingo Beckmann Journal: Support Care Cancer Date: 2018-05-05 Impact factor: 3.603
Authors: Marie A Bakitas; Tor D Tosteson; Zhigang Li; Kathleen D Lyons; Jay G Hull; Zhongze Li; J Nicholas Dionne-Odom; Jennifer Frost; Konstantin H Dragnev; Mark T Hegel; Andres Azuero; Tim A Ahles Journal: J Clin Oncol Date: 2015-03-23 Impact factor: 44.544
Authors: Michelle A Mollica; Erin E Kent; Kathleen M Castro; Erin M Ellis; Rebecca A Ferrer; Angela L Falisi; Anna Gaysynsky; Grace C Huang; Martha A Palan; Wen-Ying Sylvia Chou Journal: J Palliat Med Date: 2018-02-01 Impact factor: 2.947