Wednesday, March 11, 2009
A new study just published online in Cancer by the MD Anderson palliative care group asked this question of medical oncologists, nurse practitioners, and physician assistants at their institution in an anonymous web-based survey. Interestingly, there was a 70% response rate to the questionnaire among the 200 practitioners to whom it was sent.
The impetus for this study was apparently an observation that palliative care service referrals continue to be made late in the illness trajectory, despite efforts to encourage clinicians to use PC services earlier. The authors cite 2 studies, one in Japan (patients, families, physicians, and nurses) and one among US pediatricians and parents. These studies found that the name "palliative care" had a negative image and was a barrier to referrals (Japan) and evoked negative emotions and was less favored than "supportive care" (US). The authors decided to conduct a similar study in a large US cancer center with a well-established Palliative Care Service.
When asked what term they preferred using when discussing the referral with patients and families, only 19% preferred 'palliative.'
Fadul, N., Elsayem, A., Palmer, J., Del Fabbro, E., Swint, K., Li, Z., Poulter, V., & Bruera, E. (2009). Supportive versus palliative care: What's in a name? Cancer DOI: 10.1002/cncr.24206