Prognostic Awareness, Palliative Care Use, and Barriers to Palliative Care in Patients Undergoing Immunotherapy or Chemo-Immunotherapy for Metastatic Lung Cancer

Laurie E. McLouth; Jennifer Gabbard; Beverly J. Levine; Shannon L. Golden; Thomas W. Lycan; W. Jeffrey Petty; Kathryn E. Weaver

doi:10.1089/jpm.2022.0352

Prognostic Awareness, Palliative Care Use, and Barriers to Palliative Care in Patients Undergoing Immunotherapy or Chemo-Immunotherapy for Metastatic Lung Cancer

Laurie E. McLouth, Jennifer Gabbard, Beverly J. Levine, Shannon L. Golden, Thomas W. Lycan, W. Jeffrey Petty, Kathryn E. Weaver

Research output: Contribution to journal › Article › peer-review

Abstract

Background and Objectives: This study describes patients' prognostic awareness and palliative care use in the setting of immunotherapy for metastatic non-small cell lung cancer (mNSCLC). Design: We surveyed 60 mNSCLC patients receiving immunotherapy at a large academic medical center; conducted follow-up interviews with 12 survey participants; and abstracted palliative care use, advance directive completion, and death within a year of survey completion from the medical record. Results: Forty seven percent of patients surveyed thought they would be cured; 83% were not interested in palliative care. Interviews suggested oncologists emphasized therapeutic options when discussing prognosis and that commonly used descriptions of palliative care may exacerbate misperceptions. Only 7% had received outpatient palliative care and 8% had an advance directive a year after the survey; only 16% of the 19 patients who died had received outpatient palliative care. Conclusions: Interventions are needed to facilitate prognostic discussions and outpatient palliative care during immunotherapy. Clinical Trial Registration Number NCT03741868.

Original language	English
Pages (from-to)	831-836
Number of pages	6
Journal	Journal of Palliative Medicine
Volume	26
Issue number	6
DOIs	https://doi.org/10.1089/jpm.2022.0352
State	Published - Jun 1 2023

Bibliographical note

Funding Information:
This study was supported by the Lung Cancer Initiative of North Carolina Research Fellow Grant (L.E.M.) and the Wake Forest CTSA Grant UL1TR001420. L.E.M. was supported by NCI R25CA122061 (PI: Avis), 2 KL2 TR 001996-05A1. This study was also supported by the Qualitative and Patient-Reported Outcomes (Q-PRO) Shared Resource of the Comprehensive Cancer Center of Wake Forest University (CCCWFU), P30 CA012197.

Publisher Copyright:
© 2023, Mary Ann Liebert, Inc., publishers.

Keywords

immunotherapy
nivolumab
non-small cell lung cancer
palliative care
pembrolizumab
treatment expectations

ASJC Scopus subject areas

Nursing (all)
Anesthesiology and Pain Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1089/jpm.2022.0352

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title = "Prognostic Awareness, Palliative Care Use, and Barriers to Palliative Care in Patients Undergoing Immunotherapy or Chemo-Immunotherapy for Metastatic Lung Cancer",

abstract = "Background and Objectives: This study describes patients' prognostic awareness and palliative care use in the setting of immunotherapy for metastatic non-small cell lung cancer (mNSCLC). Design: We surveyed 60 mNSCLC patients receiving immunotherapy at a large academic medical center; conducted follow-up interviews with 12 survey participants; and abstracted palliative care use, advance directive completion, and death within a year of survey completion from the medical record. Results: Forty seven percent of patients surveyed thought they would be cured; 83% were not interested in palliative care. Interviews suggested oncologists emphasized therapeutic options when discussing prognosis and that commonly used descriptions of palliative care may exacerbate misperceptions. Only 7% had received outpatient palliative care and 8% had an advance directive a year after the survey; only 16% of the 19 patients who died had received outpatient palliative care. Conclusions: Interventions are needed to facilitate prognostic discussions and outpatient palliative care during immunotherapy. Clinical Trial Registration Number NCT03741868.",

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author = "McLouth, {Laurie E.} and Jennifer Gabbard and Levine, {Beverly J.} and Golden, {Shannon L.} and Lycan, {Thomas W.} and {Jeffrey Petty}, W. and Weaver, {Kathryn E.}",

note = "Funding Information: This study was supported by the Lung Cancer Initiative of North Carolina Research Fellow Grant (L.E.M.) and the Wake Forest CTSA Grant UL1TR001420. L.E.M. was supported by NCI R25CA122061 (PI: Avis), 2 KL2 TR 001996-05A1. This study was also supported by the Qualitative and Patient-Reported Outcomes (Q-PRO) Shared Resource of the Comprehensive Cancer Center of Wake Forest University (CCCWFU), P30 CA012197. Publisher Copyright: {\textcopyright} 2023, Mary Ann Liebert, Inc., publishers.",

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Prognostic Awareness, Palliative Care Use, and Barriers to Palliative Care in Patients Undergoing Immunotherapy or Chemo-Immunotherapy for Metastatic Lung Cancer. / McLouth, Laurie E.; Gabbard, Jennifer; Levine, Beverly J. et al.
In: Journal of Palliative Medicine, Vol. 26, No. 6, 01.06.2023, p. 831-836.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Prognostic Awareness, Palliative Care Use, and Barriers to Palliative Care in Patients Undergoing Immunotherapy or Chemo-Immunotherapy for Metastatic Lung Cancer

AU - McLouth, Laurie E.

AU - Gabbard, Jennifer

AU - Levine, Beverly J.

AU - Golden, Shannon L.

AU - Lycan, Thomas W.

AU - Jeffrey Petty, W.

AU - Weaver, Kathryn E.

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PY - 2023/6/1

Y1 - 2023/6/1

N2 - Background and Objectives: This study describes patients' prognostic awareness and palliative care use in the setting of immunotherapy for metastatic non-small cell lung cancer (mNSCLC). Design: We surveyed 60 mNSCLC patients receiving immunotherapy at a large academic medical center; conducted follow-up interviews with 12 survey participants; and abstracted palliative care use, advance directive completion, and death within a year of survey completion from the medical record. Results: Forty seven percent of patients surveyed thought they would be cured; 83% were not interested in palliative care. Interviews suggested oncologists emphasized therapeutic options when discussing prognosis and that commonly used descriptions of palliative care may exacerbate misperceptions. Only 7% had received outpatient palliative care and 8% had an advance directive a year after the survey; only 16% of the 19 patients who died had received outpatient palliative care. Conclusions: Interventions are needed to facilitate prognostic discussions and outpatient palliative care during immunotherapy. Clinical Trial Registration Number NCT03741868.

AB - Background and Objectives: This study describes patients' prognostic awareness and palliative care use in the setting of immunotherapy for metastatic non-small cell lung cancer (mNSCLC). Design: We surveyed 60 mNSCLC patients receiving immunotherapy at a large academic medical center; conducted follow-up interviews with 12 survey participants; and abstracted palliative care use, advance directive completion, and death within a year of survey completion from the medical record. Results: Forty seven percent of patients surveyed thought they would be cured; 83% were not interested in palliative care. Interviews suggested oncologists emphasized therapeutic options when discussing prognosis and that commonly used descriptions of palliative care may exacerbate misperceptions. Only 7% had received outpatient palliative care and 8% had an advance directive a year after the survey; only 16% of the 19 patients who died had received outpatient palliative care. Conclusions: Interventions are needed to facilitate prognostic discussions and outpatient palliative care during immunotherapy. Clinical Trial Registration Number NCT03741868.

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Prognostic Awareness, Palliative Care Use, and Barriers to Palliative Care in Patients Undergoing Immunotherapy or Chemo-Immunotherapy for Metastatic Lung Cancer

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

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