Increased palliative care consultation for advanced cancer patients leads to better outcomes

A recent study demonstrated that increased palliative care consultations for patients with advanced cancers is associated with substantial impact on 30-day readmission, administration of chemotherapy following discharge, hospice referral, and use of support services following discharge. The study was published on March 17 in the American Society of Clinical Oncology's (ASCO) Journal of Oncology Practice by lead author Dr. Kerin Adelson, Assistant Professor of Medical Oncology at Yale Cancer Center and Chief Quality Officer and Deputy Chief Medical Officer for Smilow Cancer Hospital, and colleagues from Mount Sinai Health System.

This is the first study of its kind to demonstrate these significant results, and it is expected that expansion of this model to other hospitals and health systems should improve the value of cancer care. "Patients with advanced cancer admitted to an acute care hospital often have short life expectancies and high morbidity," said Dr. Adelson. "For these patients, the integration of palliative care has improved symptom burden, reduced patient and caregiver distress, increased referral to hospice, and improved outcomes."

Integration of palliative care improves symptom control and decreases unwanted healthcare utilization, yet many patients are never offered these services. In this study, standardized criteria, or 'triggers' were developed for patients on the inpatient solid tumor service. Patients who met the criteria received an automatic palliative care consultation. The rates of consultation increased from 39% to 80% and the rate of 30-day readmission dropped from 35% to 18%.

In 2016 ASCO called for incorporation of palliative care into oncologic care for all patients with metastatic cancer. This study emphasizes the importance of this charge, and reiterates that patients with advanced cancer should receive dedicated palliative care services, early in their diagnosis, along with their treatment plan.