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Timing of Palliative Care Consultation Impacts End of Life Care Outcomes in Metastatic Non-Small Cell Lung Cancer

  • 0Duke Cancer Institute (C.J.O., S.C.L., T.W.L.B.,), Durham, North Carolina, USA.
Journal of Pain and Symptom Management +

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July 13, 2024

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July 13, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Early palliative care (PC) integration in metastatic non-small cell lung cancer (mNSCLC) improves end-of-life care and survival. Despite benefits, PC referrals remain low and often delayed, impacting patient outcomes.

Area Of Science

  • Oncology
  • Palliative Care
  • Health Services Research

Background

  • Early palliative care (PC) improves quality of life, end-of-life (EoL) care, and survival in metastatic non-small cell lung cancer (mNSCLC).
  • Despite established benefits, PC utilization in mNSCLC remains suboptimal, particularly with evolving treatment paradigms.

Purpose Of The Study

  • To investigate the impact of timing and extent of PC involvement on patient outcomes and experience in mNSCLC.
  • To analyze PC utilization patterns in the context of modern NSCLC therapies, including immunotherapy.

Main Methods

  • Retrospective review of mNSCLC patients receiving first-line chemotherapy, immunotherapy, or chemoimmunotherapy.
  • Data abstraction for PC consultation timing, EoL care variables, and outcomes.
  • Descriptive statistical analysis of EoL care indicators.

Main Results

  • 47% of 152 mNSCLC patients received PC; 53% did not.
  • Early PC consultation (within 2 months) was associated with longer hospice time (35 days), lower aggressive EoL care rates (43%), and less in-hospital death (14%).
  • Late or no PC referrals were common, indicating a gap in integration.

Conclusions

  • Late or absent palliative care referrals persist in mNSCLC, despite proven benefits of early integration.
  • Early outpatient PC referrals are linked to improved outcomes, including longer hospice duration and reduced aggressive end-of-life care.
  • Optimizing early PC integration is crucial for enhancing patient care and outcomes in mNSCLC.

Keywords:

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