Implementing WHO recommendations for palliative care into routine lung cancer therapy: a feasibility project

Area of Science:

• Oncology
• Palliative Care
• Healthcare Management

Background:

• The World Health Organization (WHO) advocates for early integration of palliative care (PC) in disease trajectories.
• A comprehensive cancer center aimed to implement this recommendation into administrative directives for cancer care.
• The study focused on lung cancer patients to evaluate the timing of PC integration.

Purpose of the Study:

• To determine at what point in the disease trajectory lung cancer patients received their first palliative care consultation.
• To assess if earlier integration of PC could be achieved over a one-year period.
• To analyze patient condition, symptom burden, and survival post-initial PC consultation.

Main Methods:

• Retrospective systematic chart analysis over a two-year period.
• Evaluation of the physical condition, symptom burden (e.g., dyspnea, pain), and proximity to death at first PC consultation.
• Analysis of changes in PC integration and support requests over one year.

Main Results:

• Most lung cancer patients presented with reduced physical status and significant symptom burden at their first PC consultation.
• Many patients died shortly after their initial PC consultation.
• Over one year, there was a decrease in identified symptoms and inpatient PC admissions, with increased requests for psychosocial support.

Conclusions:

• While progress in understanding PC competencies and early integration was observed, WHO recommendations alone did not ensure early PC integration into routine cancer care.
• Disease-specific guidelines are advocated to facilitate earlier and more effective palliative care delivery.
• Further strategies are needed to embed palliative care earlier in the cancer patient journey.