Paging Palliative Care: Barriers to Referral and Why Rheumatologists Aren't Making the Call (Yet).

Area of Science:

• Rheumatology
• Palliative Care
• Healthcare Integration

Background:

• Serious rheumatic diseases are associated with high morbidity and mortality.
• Palliative care (PC) is underutilized in rheumatology despite its potential benefits.
• Knowledge gaps exist regarding barriers to PC integration in rheumatology.

Purpose of the Study:

• To identify provider-specific barriers to palliative care referral for patients with serious rheumatic diseases.
• To understand the perspectives of both rheumatologists and palliative care providers on referral challenges.

Main Methods:

• Surveys were distributed to rheumatology and palliative care providers across the United States.
• Data were collected via email and at professional conferences.
• Statistical analyses included descriptive statistics, Fisher's exact test, and two-sample t-tests.

Main Results:

• Rheumatologists cited uncertainty about referral timing (50%), patient perception of PC as "giving up" (49%), and perceived low patient need (40%) as key barriers.
• Palliative care providers identified lack of knowledge regarding rheumatic disease prognosis (66%), treatments (61%), and disease course (53%) as primary obstacles.

Conclusions:

• Rheumatologists require clearer guidelines on when and how to refer patients to PC.
• Palliative care providers need enhanced understanding of rheumatic diseases to effectively manage these patients.
• Addressing these barriers is crucial for improving PC access for individuals with rheumatic conditions.