End-of-life care gains increasing prominence

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Palliative care team approach looks promising

Regarding Dr. Chen’s study, this study does find that we can provide support to patients and their families with appropriately staffed and trained medical teams that specialize in palliative care to really decrease futile, invasive, and expensive care at the end of life. This is broad implications to our patients and their families as they talk about prognosis with their physicians, and also to the physicians taking care of these patients, who may have not had a longitudinal relationship with these patients. Immediate feedback to the caring physicians can decrease some of these high resource utilization maneuvers that don’t provide improvement in quality of life.

Dr. Jyoti D. Patel is a member of ASCO’s Cancer Communications Committee and a thoracic oncologist at Northwestern University, Chicago. She gave these remarks in an online press conference organized by ASCO.


Outpatient palliative care: Dr. Kavitha Ramchandran and her associates at Stanford (Calif.) University studied their system’s electronic medical records to look at the use of palliative care in outpatient clinics from January through September 2012. The number of palliative care contacts with outpatient clinic patients increased from 10 in January to 45 in September. The number of physicians referring outpatients to palliative care increased from 6 in January to 21 in September, she said in a poster presentation.

More than 65% of patients who were referred for palliative care were younger than 65 years, said Dr. Ramchandran of the university. Most patients had only one visit with palliative care (41%) or two visits (23%).

The findings suggest that outpatient palliative care is a growing specialty, she suggested. The data are not mature enough to assess any impact on the quality of end-of-life care or on the efficiency of care, she added.

Dr. Chen and Mr. Pesavento reported having no financial disclosures. Dr. Ramchandran’s study was funded in part by the Stanford Corporate Partners Fund and by various Stanford departments. No financial disclosures were available for the other presenters.


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