TY - JOUR
T1 - Palliative care use and utilization determinants among patients treated for advanced stage lung cancer care in the community and academic medical setting
AU - McLouth, Laurie E.
AU - Borger, Tia
AU - Bursac, Vilma
AU - Hoerger, Michael
AU - McFarlin, Jessica
AU - Shelton, Shaylla
AU - Shelton, Brent
AU - Shearer, Andrew
AU - Kiviniemi, Marc T.
AU - Stapleton, Jerod L.
AU - Mullett, Timothy
AU - Studts, Jamie L.
AU - Goebel, David
AU - Thind, Ravneet
AU - Trice, Laura
AU - Schoenberg, Nancy E.
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2023/3
Y1 - 2023/3
N2 - 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.
AB - 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.
KW - Advanced stage lung cancer
KW - Barriers
KW - Facilitators
KW - Palliative care
UR - http://www.scopus.com/inward/record.url?scp=85148968560&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85148968560&partnerID=8YFLogxK
U2 - 10.1007/s00520-023-07649-y
DO - 10.1007/s00520-023-07649-y
M3 - Article
C2 - 36847880
AN - SCOPUS:85148968560
SN - 0941-4355
VL - 31
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 3
M1 - 190
ER -