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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
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 t...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9969037/ https://www.ncbi.nlm.nih.gov/pubmed/36847880 http://dx.doi.org/10.1007/s00520-023-07649-y |
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author | McLouth, Laurie E. Borger, Tia Bursac, Vilma Hoerger, Michael McFarlin, Jessica Shelton, Shaylla Shelton, Brent Shearer, Andrew Kiviniemi, Marc T. Stapleton, Jerod L. Mullett, Timothy Studts, Jamie L. Goebel, David Thind, Ravneet Trice, Laura Schoenberg, Nancy E. |
author_facet | McLouth, Laurie E. Borger, Tia Bursac, Vilma Hoerger, Michael McFarlin, Jessica Shelton, Shaylla Shelton, Brent Shearer, Andrew Kiviniemi, Marc T. Stapleton, Jerod L. Mullett, Timothy Studts, Jamie L. Goebel, David Thind, Ravneet Trice, Laura Schoenberg, Nancy E. |
author_sort | McLouth, Laurie E. |
collection | PubMed |
description | 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00520-023-07649-y. |
format | Online Article Text |
id | pubmed-9969037 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-99690372023-02-28 Palliative care use and utilization determinants among patients treated for advanced stage lung cancer care in the community and academic medical setting McLouth, Laurie E. Borger, Tia Bursac, Vilma Hoerger, Michael McFarlin, Jessica Shelton, Shaylla Shelton, Brent Shearer, Andrew Kiviniemi, Marc T. Stapleton, Jerod L. Mullett, Timothy Studts, Jamie L. Goebel, David Thind, Ravneet Trice, Laura Schoenberg, Nancy E. Support Care Cancer Research 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00520-023-07649-y. Springer Berlin Heidelberg 2023-02-27 2023 /pmc/articles/PMC9969037/ /pubmed/36847880 http://dx.doi.org/10.1007/s00520-023-07649-y Text en © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Research McLouth, Laurie E. Borger, Tia Bursac, Vilma Hoerger, Michael McFarlin, Jessica Shelton, Shaylla Shelton, Brent Shearer, Andrew Kiviniemi, Marc T. Stapleton, Jerod L. Mullett, Timothy Studts, Jamie L. Goebel, David Thind, Ravneet Trice, Laura Schoenberg, Nancy E. Palliative care use and utilization determinants among patients treated for advanced stage lung cancer care in the community and academic medical setting |
title | Palliative care use and utilization determinants among patients treated for advanced stage lung cancer care in the community and academic medical setting |
title_full | Palliative care use and utilization determinants among patients treated for advanced stage lung cancer care in the community and academic medical setting |
title_fullStr | Palliative care use and utilization determinants among patients treated for advanced stage lung cancer care in the community and academic medical setting |
title_full_unstemmed | Palliative care use and utilization determinants among patients treated for advanced stage lung cancer care in the community and academic medical setting |
title_short | Palliative care use and utilization determinants among patients treated for advanced stage lung cancer care in the community and academic medical setting |
title_sort | palliative care use and utilization determinants among patients treated for advanced stage lung cancer care in the community and academic medical setting |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9969037/ https://www.ncbi.nlm.nih.gov/pubmed/36847880 http://dx.doi.org/10.1007/s00520-023-07649-y |
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