PURPOSE: To describe current referral practices of oncologists to specialized palliative care (SPC) and define demographic characteristics, practice situations, and opinions associated with referral. METHODS:Physician members of the Canadian Association of Medical Oncologists, Canadian Association of Radiation Oncologists, and Canadian Society of Surgical Oncology were invited to participate in an anonymous survey assessing SPC referral practices. Participants received two e-mailed and two mailed invitations. RESULTS: The response rate was 72% (603 of 839 physicians); 37% were medical oncologists/hematologists, 50% were radiation oncologists, and 12% were surgical oncologists. Ninety-four percent reported that SPC was available to them, but only 37% reported that these services accepted patients on chemotherapy. Eighty-four percent referred terminally ill patients usually/always, but generally for uncontrolled symptoms or discharge planning late in the disease course. One third would refer to SPC earlier if it was renamed supportive care. Predictors of higher referral frequency included comprehensiveness of available SPC services (P = .004), satisfaction with SPC availability (P < .001), SPC acceptance of patients receiving chemotherapy (P < .001), and oncologist ease with referring patients to a palliative care service before they were close to death (P < .001). Controlling for specialty, predictors of referral at diagnosis or during chemotherapy, rather than later, included satisfaction with SPC service availability (P < .001) and SPC service acceptance of patients on chemotherapy (P < .001). CONCLUSION: Oncologists referred patients frequently to SPC, but generally late in the disease course for patients with uncontrolled symptoms. Availability of comprehensive SPC, especially for patients receiving chemotherapy, and persisting definitional issues seem to be the main barriers preventing timely referral.
RCT Entities:
PURPOSE: To describe current referral practices of oncologists to specialized palliative care (SPC) and define demographic characteristics, practice situations, and opinions associated with referral. METHODS: Physician members of the Canadian Association of Medical Oncologists, Canadian Association of Radiation Oncologists, and Canadian Society of Surgical Oncology were invited to participate in an anonymous survey assessing SPC referral practices. Participants received two e-mailed and two mailed invitations. RESULTS: The response rate was 72% (603 of 839 physicians); 37% were medical oncologists/hematologists, 50% were radiation oncologists, and 12% were surgical oncologists. Ninety-four percent reported that SPC was available to them, but only 37% reported that these services accepted patients on chemotherapy. Eighty-four percent referred terminally ill patients usually/always, but generally for uncontrolled symptoms or discharge planning late in the disease course. One third would refer to SPC earlier if it was renamed supportive care. Predictors of higher referral frequency included comprehensiveness of available SPC services (P = .004), satisfaction with SPC availability (P < .001), SPC acceptance of patients receiving chemotherapy (P < .001), and oncologist ease with referring patients to a palliative care service before they were close to death (P < .001). Controlling for specialty, predictors of referral at diagnosis or during chemotherapy, rather than later, included satisfaction with SPC service availability (P < .001) and SPC service acceptance of patients on chemotherapy (P < .001). CONCLUSION: Oncologists referred patients frequently to SPC, but generally late in the disease course for patients with uncontrolled symptoms. Availability of comprehensive SPC, especially for patients receiving chemotherapy, and persisting definitional issues seem to be the main barriers preventing timely referral.
Authors: Ariel Shalev; Veerawat Phongtankuel; Elissa Kozlov; Megan Johnson Shen; Ronald D Adelman; M C Reid Journal: Am J Hosp Palliat Care Date: 2017-06-20 Impact factor: 2.500
Authors: Justin A Yu; Kristin N Ray; Seo Young Park; Amanda Barry; Cardinale B Smith; Peter G Ellis; Yael Schenker Journal: J Oncol Pract Date: 2018-11-08 Impact factor: 3.840
Authors: Anna Sorensen; Kirsten Wentlandt; Lisa W Le; Nadia Swami; Breffni Hannon; Gary Rodin; Monika K Krzyzanowska; Camilla Zimmermann Journal: Support Care Cancer Date: 2019-06-04 Impact factor: 3.603
Authors: Christopher T Lim; Avia Tadmor; Daisuke Fujisawa; James J MacDonald; Emily R Gallagher; Justin Eusebio; Vicki A Jackson; Jennifer S Temel; Joseph A Greer; Teresa Hagan; Elyse R Park Journal: J Palliat Med Date: 2017-04-07 Impact factor: 2.947
Authors: Camilla Zimmermann; Dora Yuen; Ashley Mischitelle; Mark D Minden; Joseph M Brandwein; Aaron Schimmer; Lucia Gagliese; Christopher Lo; Anne Rydall; Gary Rodin Journal: Leuk Res Date: 2013-03-11 Impact factor: 3.156
Authors: Teresa Hagan Thomas; Vicki A Jackson; Heather Carlson; Simone Rinaldi; Angela Sousa; Andrea Hansen; Mihir Kamdar; Juliet Jacobsen; Elyse R Park; William F Pirl; Jennifer S Temel; Joseph A Greer Journal: J Palliat Med Date: 2018-10-25 Impact factor: 2.947