Highlights from the 2014 Palliative Care in Oncology Symposium

Dec 18, 2014

The inaugural 2014 Palliative Care in Oncology Symposium was held October 24-25, 2014, in Boston, Massachusetts. Over 200 abstracts were presented, covering topics such as the integration of palliative care into treatment and the financial hardships facing people living with cancer. The following abstracts were among those highlighted in the ASCO Press Program.

“Co-rounding” of medical oncologists and palliative care physicians improves outcomes
Three daily, formal meetings betweenmedical oncologists and palliativecare specialists in a medical oncologyinpatient unit were associated with significantimprovements in both health system-related and patient-relatedoutcomes (Abstract 3). The studyfound that the 783 patients in the “co-rounding”intervention group had asignificant decrease in mean length ofhospital stay (4.17 days vs. 4.51 days;p = 0.02), compared to the 731patients admitted before the onsetof the intervention. The interventiongroup also showed significant improvementin 7- and 30-day readmissionrates (15% and 23% reduction, respectively[p = 0.03, p = 0.05]).

“To our knowledge, this is the firstexample where palliative care physiciansand medical oncologists areworking side by side every day on aninpatient oncology ward,” said leadstudy author Richard Riedel, MD, anAssociate Professor of Medicine andMedical Director at Duke UniversityMedical Center.

“Smart technology” system improves symptoms of hospice patients and caregivers
Early findings from astudy of 319 families suggestthat the use of atelephone-based systemthat monitors symptomsand provides healthcoaching to caregiversleads to decreased symptomsamong patientsand their caregivers in the final weeksof life (Abstract 85). The symptomcare (SC) intervention allowed familycaregivers to call into the automatedsystem to report on the presence andseverity of patient symptoms andthe severity of their own distress andsymptoms. The automated systemthen provided customized, real-timecoaching, such as how to improve thepatient’s breathing. Preliminary analysesindicated that the family caregivers’combined symptoms improvedmore in the SC group (p = 0.003, mixedeffects model), as did patient symptoms(p = 0.003).

Financial and work-related hardships among U.S. cancer survivors
Twenty-seven percent of cancer survivorshave at least one financial problem,such as debt or bankruptcy, and37% have to modify work plans—forexample, switching to a less-demandingjob—due to a cancer diagnosis(Abstract 238), according to a studyout of the University of California,Davis that explored disparities in financialburden among a large, nationallyrepresentative group of 1,592 cancersurvivors. Women, younger survivors,racial and ethnic minorities, and uninsuredsurvivors were disproportionatelyburdened.

Insured patients alter lifestyle, medical care to cope with cost of cancer treatment
A small nationwide survey of 174patients found that some insuredpatients are changing their lifestyleand medical care to cope with cancertreatment costs—with some modificationspotentially jeopardizing theirmedical care (Abstract 161). The studyfound that 89% of survey participantsused at least one lifestyle-alteringstrategy, such as spending less onbasics like food and clothing (57%),and 39% used at least one medicalcare-altering strategy, such as not fillinga prescription (28%). Younger age,higher education, and shorter time onchemotherapy were associated withgreater likelihood of adopting lifestylecoping strategies.

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