Cited by 218Palliative Care and End-of-Life IssuesPalliative and Oncologic CarePain Management and Opioid Use

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Access to Palliative Care Among Patients Treated at a Comprehensive Cancer Center

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Hui, David, Kim, Sun-Hyun, Kwon, Jung Hye, Tanco, Kimberson Cochien, Zhang, Tao, Kang, Jung Hun, Rhondali, Wadih, Chisholm, Gary, Bruera, Eduardo·2012·The Oncologist

DOI 10.1634/theoncologist.2012-0192PMC PMC3528390

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Abstract

Background.: Palliative care (PC) is a critical component of comprehensive cancer care. Previous studies on PC access have mostly examined the timing of PC referral. The proportion of patients who actually receive PC is unclear. We determined the proportion of cancer patients who received PC at our comprehensive cancer center and the predictors of PC referral. Methods.: We reviewed the charts of consecutive patients with advanced cancer from the Houston region seen at MD Anderson Cancer Center who died between September 2009 and February 2010. We compared patients who received PC services with those who did not receive PC services before death. Results.: In total, 366 of 816 (45%) decedents had a PC consultation. The median interval between PC consultation and death was 1.4 months (interquartile range, 0.5–4.2 months) and the median number of medical team encounters before PC was 20 (interquartile range, 6–45). On multivariate analysis, older age, being married, and specific cancer types (gynecologic, lung, and head and neck) were significantly associated with a PC referral. Patients with hematologic malignancies had significantly fewer PC referrals (33%), the longest interval between an advanced cancer diagnosis and PC consultation (median, 16 months), the shortest interval between PC consultation and death (median, 0.4 months), and one of the largest numbers of medical team encounters (median, 38) before PC. Conclusions.: We found that a majority of cancer patients at our cancer center did not access PC before they died. PC referral occurs late in the disease process with many missed opportunities for referral.

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Authors: Hui, D., Kim, S.-H., Kwon, J. H., Tanco, K. C., Zhang, T., Kang, J. H., Rhondali, W., Chisholm, G., & Bruera, E.
Affiliations: The University of Texas MD Anderson Cancer Center (US)
Corresponding author: Hui, David
ORCID: Hui, David
Kim, Sun-Hyun
Kwon, Jung Hye
Tanco, Kimberson Cochien
Zhang, Tao
Kang, Jung Hun
Rhondali, Wadih
Chisholm, Gary
Bruera, Eduardo
Venue: The Oncologist
Publisher: Oxford University Press (OUP)
Published: 2012-12-01
Volume: 17
Issue: 12
Pages: 1574-1580
ISSN: 1083-7159 (ISSN-L)
1549-490X
DOI: 10.1634/theoncologist.2012-0192
PMC: PMC3528390
OpenAlex: W2149149861
Cited by: 218
References: 37
Citations by year: 2026: 2 · 2025: 12 · 2024: 20 · 2023: 10 · 2022: 18 · 2021: 11 · 2020: 24 · 2019: 25 · 2018: 23 · 2017: 15 · 2016: 15 · 2015: 19 · 2014: 15 · 2013: 7 · 2012: 1
FWCI: 12.98
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations: The Oncologist (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: University of Texas MD Anderson Cancer Center
National Cancer Institute (P30CA016672)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords: access to palliative care, palliative care referral, advanced cancer, comprehensive cancer center, hematologic malignancies, predictors of referral, referral timing
MeSH terms: Adult, Aged, Aged, 80 and over, Comprehensive Health Care, Female, Humans, Male, Middle Aged, Neoplasms, Palliative Care, Referral and Consultation, Retrospective Studies, Multivariate Analysis, Logistic Models, Young Adult

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