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Referrals to palliative care come too late to improve quality of life for cancer patients

report having discussions with physicians about end of life care (55%), compared to those who thought referral time was appropriate (79%). Of the families who did not have such conversations, factors included family unwillingness (14%), patient unwillingness (18%), and physician unwillingness (57%).

Families who reported late or very late referrals were two times more likely to believe before admission that palliative care shortens patient lives. They were also more likely to report feeling unprepared for changes in the patient's condition as he or she neared the end of life.

Researchers found, however, that families' perceptions of palliative care changed significantly once patients were admitted to palliative care units. Among 257 families who had low expectations before admission, 101 (39%) reported that the care was much better than expected, 76 families (30%) said it was better, while only 12 (4.7%) reported that care was worse.

An accompanying editorial by Betty Ferrell, PHD, FAAN, research scientist, City of Hope National Medical Center, notes that this study has great significance for people living with cancer in all countries.

"There is international recognition about the need to ease what is an incredibly difficult decision for patients and families about palliative care and increase earlier referrals to such programs," Dr. Ferrell said. "This study supports closer collaboration between oncologists and palliative care specialists, rather than simply a swift transfer from one provider to the other as the patient's condition declines."


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22-Feb-2005


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