The utilization and impact of oncology supportive care clinics on patients with metastatic lung cancer
| Autor: | Matthew T Chin, Yan S. Kim, Gabriel J. Escobar, Esther J Luo, Sudhir Rajan, Shelley Leong |
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| Rok vydání: | 2017 |
| Předmět: | |
| Zdroj: | Journal of Clinical Oncology. 35:123-123 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2017.35.31_suppl.123 |
| Popis: | 123 Background: The American Society of Clinical Oncology has endorsed early integration of oncology with palliative care. In 2012, Kaiser Permanente Northern California (KPNC) introduced Oncology Supportive Care Clinics (OSCCs). OSCCs are outpatient palliative care clinics designed to incorporate palliative care into standard oncology practice at the time of a patient's cancer diagnosis. This study examines the utilization and impact of OSCCs on patients with metastatic lung cancer. Methods: We identified adult patients with incidental stage IV lung cancer using the KPNC cancer registry from 2012-2015 and followed them for 12 months. We ascertained OSCC utilization using KPNC’s electronic health record. We examined the patterns of OSCC referral/utilization and compared survival, in-hospital death, and treatment received in patients who used and did not use OSCC services. Results: A total of 607 patients were included and 245 (40.4%) were referred to OSCC. The median time from diagnosis to referral was 48 days and ¼ were referred within 15 days. The majority (86%) of the patients referred were seen by OSCC. Only 22 patients (9.0%) refused to be seen. We found no large patient- or facility-level differences between patients referred and not referred to OSCC. At the end of follow up, 398 (65.6%) of the patients died. Patients seen by OSCC were less likely to die (59.2% vs. 68.9%, p < 0.02) at 1 year. Fewer patients who used OSCC died in the hospital compared to those who did not (26 or 12.3% vs. 67 or 16.9%); however, it did not achieve statistical significance (p = 0.13). Among patients who used OSCC, 166 (78.7%) received anti-cancer treatment, compared to 221 (55.8%) among those who did not (p < 0.001). Conclusions: Despite having a robust infrastructure and integrated system in place, over half of the patients diagnosed with metastatic lung cancer did not receive a referral. Future work is needed to understand the reasons why so many patients were not referred. Furthermore, our data showed that receiving OSCC services did not adversely impact survival and the receipt of anti-cancer treatment. These findings serve to reassure patients and providers that the addition of palliative care does not harm patients or limit their treatment. |
| Databáze: | OpenAIRE |
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