Journal scan

US study looks at outpatient palliative care referral patterns in oncologists

Understanding outpatient palliative care referrals among thoracic medical oncologists

Understanding outpatient palliative care referrals among thoracic medical oncologists

Picture: Science Photo Library

For people with lung cancer, the likelihood and scheduling of referral to palliative care services is variable and relatively dependent on the age and experience of their oncologist, according to a recent study.

Using a retrospective cohort study design, researchers from the University of Texas MD Anderson Cancer Center reviewed data on consecutive advanced thoracic malignancy adult patients over a five-year period. The data of 1,642 deceased people seen by 26 medical oncologists were included in the study. The average age of the patient was 65 years; 54% were male; the majority of patients were diagnosed with non-small cell lung cancer (85%); most had metastatic disease (92%).

The findings suggested one in three patients were referred to palliative care services before death. With metastatic disease, younger and non-white race patients were characteristics associated with greater referral rates. Similarly, younger medical oncologists were found to be the practitioner most likely to refer to palliative care services; the average age of high referring clinicians was 45 years compared to the low referring group age of 56 years.

The high referring oncologists were also found to have fewer years of post-registration experience – an average of 20 years vs 30 years for the lower referring group.

The patients of high referring younger doctors were also more likely to be referred earlier in their disease experience with a median period between oncology and palliative care consultations of 90-days versus 170-days.

Hui D, Kilgore K, Park M et al (2018) Patterns and predictors of outpatient palliative care referral among thoracic medical oncologists. The Oncologist. doi:10.1634/theoncologist.2018-0094

This article is for subscribers only