Palliative care, a type of healthcare for patients with life-threatening diseases, focuses on improving quality of life and managing pain. Unlike healthcare professionals who treat diseases or illnesses, palliative care practitioners focus on alleviating the symptoms of a disease or the side effects associated with a treatment. For cancer patients, palliative care can include standard therapies, like chemotherapy or radiation, particularly when geared at shrinking a tumor causing pain. Importantly, cancer patients may receive palliative care at the same time as they receive cancer treatments. Palliative care can also include support for caretakers and family members of cancer patients.
Palliative care practitioners provide holistic care aimed at benefiting the physical, emotional, social, and spiritual needs of cancer patients. Specialists can work effectively in a team setting, including those with diverse job roles and specialties. Members of a palliative care team can include doctors, nurses, dieticians, pharmacists, occupational and physical therapists, members of the clergy or chaplains, mental health professionals, and social workers.
In recent years, palliative care practice has increased, due in part to the accessibility of telehealth platforms and the expansion of programs to educate and train specialists in the tenets of palliative care. To better understand how these changes have impacted the field of palliative care, a team of researchers conducted a retrospective study investigating the last year of life of individuals diagnosed with cancers with poor prognoses. Diagnoses considered poor-prognosis cancers included cases of cancers that commonly caused death, rare cancers with high mortality rates, or solid tumors with distant metastases. The researchers recently published their findings in JAMA Network Open.
The study included 1,508,103 Medicare beneficiaries who died from poor-prognosis cancers between 2018 and 2023. In 2018, 29.84% of patients had at least one palliative care encounter, and by 2023, this proportion had increased to 37.21%. Similarly, outpatient palliative care encounters rose from 10.66% to 20.56%.
Most (22.84%) patients receiving palliative care in 2023 received their treatment from advanced practice clinicians, with smaller percentages receiving care from self-designated palliative care physicians (15.6%) or other physicians (9.92%). Notably, while palliative care from self-designated palliative care physicians and other physicians stayed somewhat consistent between 2018 and 2023, the researchers observed a more than 7% increase in encounters with advanced practice clinicians.
Telehealth appointments accounted for nearly 20% of outpatient palliative care encounters in 2023. Older patients, those with low income, and those living in rural areas appeared less likely to receive specialty palliative care.
Overall, the study concluded that an increasing proportion of patients with poor-prognosis cancer received palliative care, and the number of patients cared for by enhanced practice specialists increased significantly. Despite these trends, less than half of patients with poor-prognosis cancers received palliative care. Thus, this study presents a need for new strategies to increase access and education about palliative care options.
Sources: JAMA Netw Open