Palliative Care Specialist Consultation Is Associated With Supportive Care Quality in Advanced Cancer

Anne M. Walling; Diana Tisnado; Susan L. Ettner; Steven M. Asch; Sydney M. Dy; Philip Pantoja; Martin Lee; Sangeeta C. Ahluwalia; Hannah Schreibeis-Baum; Jennifer L. Malin; Karl A. Lorenz

doi:10.1016/j.jpainsymman.2016.04.005

Palliative Care Specialist Consultation Is Associated With Supportive Care Quality in Advanced Cancer

Anne M. Walling, Diana Tisnado, Susan L. Ettner, Steven M. Asch, Sydney M. Dy, Philip Pantoja, Martin Lee, Sangeeta C. Ahluwalia, Hannah Schreibeis-Baum, Jennifer L. Malin, Karl A. Lorenz

Bloomberg School of Public Health

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Context Although recent randomized controlled trials support early palliative care for patients with advanced cancer, the specific processes of care associated with these findings and whether these improvements can be replicated in the broader health care system are uncertain. Objectives The aim of this study was to evaluate the occurrence of palliative care consultation and its association with specific processes of supportive care in a national cohort of Veterans using the Cancer Quality ASSIST (Assessing Symptoms Side Effects and Indicators of Supportive Treatment) measures. Methods We abstracted data from 719 patients' medical records diagnosed with advanced lung, colorectal, or pancreatic cancer in 2008 over a period of three years or until death who received care in the Veterans Affairs Health System to evaluate the association of palliative care specialty consultation with the quality of supportive care overall and by domain using a multivariate regression model. Results All but 54 of 719 patients died within three years and 293 received at least one palliative care consult. Patients evaluated by a palliative care specialist at diagnosis scored seven percentage points higher overall (P < 0.001) and 11 percentage points higher (P < 0.001) within the information and care planning domain compared with those without a consult. Conclusion Early palliative care specialist consultation is associated with better quality of supportive care in three advanced cancers, predominantly driven by improvements in information and care planning. This study supports the effectiveness of early palliative care consultation in three common advanced cancers within the Veterans Affairs Health System and provides a greater understanding of what care processes palliative care teams influence.

Original language	English (US)
Pages (from-to)	507-514
Number of pages	8
Journal	Journal of Pain and Symptom Management
Volume	52
Issue number	4
DOIs	https://doi.org/10.1016/j.jpainsymman.2016.04.005
State	Published - Oct 1 2016

Keywords

Advanced cancer
palliative care
quality

ASJC Scopus subject areas

General Nursing
Clinical Neurology
Anesthesiology and Pain Medicine

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10.1016/j.jpainsymman.2016.04.005

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Walling, A. M., Tisnado, D., Ettner, S. L., Asch, S. M., Dy, S. M., Pantoja, P., Lee, M., Ahluwalia, S. C., Schreibeis-Baum, H., Malin, J. L., & Lorenz, K. A. (2016). Palliative Care Specialist Consultation Is Associated With Supportive Care Quality in Advanced Cancer. Journal of Pain and Symptom Management, 52(4), 507-514. https://doi.org/10.1016/j.jpainsymman.2016.04.005

@article{1c05006c2c7a469f858e05bcea582537,

title = "Palliative Care Specialist Consultation Is Associated With Supportive Care Quality in Advanced Cancer",

abstract = "Context Although recent randomized controlled trials support early palliative care for patients with advanced cancer, the specific processes of care associated with these findings and whether these improvements can be replicated in the broader health care system are uncertain. Objectives The aim of this study was to evaluate the occurrence of palliative care consultation and its association with specific processes of supportive care in a national cohort of Veterans using the Cancer Quality ASSIST (Assessing Symptoms Side Effects and Indicators of Supportive Treatment) measures. Methods We abstracted data from 719 patients' medical records diagnosed with advanced lung, colorectal, or pancreatic cancer in 2008 over a period of three years or until death who received care in the Veterans Affairs Health System to evaluate the association of palliative care specialty consultation with the quality of supportive care overall and by domain using a multivariate regression model. Results All but 54 of 719 patients died within three years and 293 received at least one palliative care consult. Patients evaluated by a palliative care specialist at diagnosis scored seven percentage points higher overall (P < 0.001) and 11 percentage points higher (P < 0.001) within the information and care planning domain compared with those without a consult. Conclusion Early palliative care specialist consultation is associated with better quality of supportive care in three advanced cancers, predominantly driven by improvements in information and care planning. This study supports the effectiveness of early palliative care consultation in three common advanced cancers within the Veterans Affairs Health System and provides a greater understanding of what care processes palliative care teams influence.",

keywords = "Advanced cancer, palliative care, quality",

author = "Walling, {Anne M.} and Diana Tisnado and Ettner, {Susan L.} and Asch, {Steven M.} and Dy, {Sydney M.} and Philip Pantoja and Martin Lee and Ahluwalia, {Sangeeta C.} and Hannah Schreibeis-Baum and Malin, {Jennifer L.} and Lorenz, {Karl A.}",

note = "Funding Information: This article is based on work supported by the U.S. Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development Service (Project # IIR 09–097). The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the U.S. government. Since July 2013, Dr. Walling has also been supported by the National Institutes of Health (NIH)/ National Center for Advancing Translational Science UCLA CTSI grant ( UL1TR000124 ) and the NIH Loan Repayment Program. The funding source had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript. Drs Walling, Tisnado, Ettner, Asch, Dy, Lee, Ahluwalia, Schreibeis-Baum, and Pantoja do not have any relevant financial interests, activities, or relationships within the past three years to report. Dr. Malin is employed by and has stock ownership with Anthem. Dr. Lorenz is serving as a consultant to Otsuka Pharmaceuticals for data monitoring and safety in the evaluation of a Phase II trial of Sativex, a novel cannabinoid analgesic. Publisher Copyright: {\textcopyright} 2016",

year = "2016",

month = oct,

day = "1",

doi = "10.1016/j.jpainsymman.2016.04.005",

language = "English (US)",

volume = "52",

pages = "507--514",

journal = "Journal of Pain and Symptom Management",

issn = "0885-3924",

publisher = "Elsevier Inc.",

number = "4",

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TY - JOUR

T1 - Palliative Care Specialist Consultation Is Associated With Supportive Care Quality in Advanced Cancer

AU - Walling, Anne M.

AU - Tisnado, Diana

AU - Ettner, Susan L.

AU - Asch, Steven M.

AU - Dy, Sydney M.

AU - Pantoja, Philip

AU - Lee, Martin

AU - Ahluwalia, Sangeeta C.

AU - Schreibeis-Baum, Hannah

AU - Malin, Jennifer L.

AU - Lorenz, Karl A.

N1 - Funding Information: This article is based on work supported by the U.S. Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development Service (Project # IIR 09–097). The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the U.S. government. Since July 2013, Dr. Walling has also been supported by the National Institutes of Health (NIH)/ National Center for Advancing Translational Science UCLA CTSI grant ( UL1TR000124 ) and the NIH Loan Repayment Program. The funding source had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript. Drs Walling, Tisnado, Ettner, Asch, Dy, Lee, Ahluwalia, Schreibeis-Baum, and Pantoja do not have any relevant financial interests, activities, or relationships within the past three years to report. Dr. Malin is employed by and has stock ownership with Anthem. Dr. Lorenz is serving as a consultant to Otsuka Pharmaceuticals for data monitoring and safety in the evaluation of a Phase II trial of Sativex, a novel cannabinoid analgesic. Publisher Copyright: © 2016

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Context Although recent randomized controlled trials support early palliative care for patients with advanced cancer, the specific processes of care associated with these findings and whether these improvements can be replicated in the broader health care system are uncertain. Objectives The aim of this study was to evaluate the occurrence of palliative care consultation and its association with specific processes of supportive care in a national cohort of Veterans using the Cancer Quality ASSIST (Assessing Symptoms Side Effects and Indicators of Supportive Treatment) measures. Methods We abstracted data from 719 patients' medical records diagnosed with advanced lung, colorectal, or pancreatic cancer in 2008 over a period of three years or until death who received care in the Veterans Affairs Health System to evaluate the association of palliative care specialty consultation with the quality of supportive care overall and by domain using a multivariate regression model. Results All but 54 of 719 patients died within three years and 293 received at least one palliative care consult. Patients evaluated by a palliative care specialist at diagnosis scored seven percentage points higher overall (P < 0.001) and 11 percentage points higher (P < 0.001) within the information and care planning domain compared with those without a consult. Conclusion Early palliative care specialist consultation is associated with better quality of supportive care in three advanced cancers, predominantly driven by improvements in information and care planning. This study supports the effectiveness of early palliative care consultation in three common advanced cancers within the Veterans Affairs Health System and provides a greater understanding of what care processes palliative care teams influence.

AB - Context Although recent randomized controlled trials support early palliative care for patients with advanced cancer, the specific processes of care associated with these findings and whether these improvements can be replicated in the broader health care system are uncertain. Objectives The aim of this study was to evaluate the occurrence of palliative care consultation and its association with specific processes of supportive care in a national cohort of Veterans using the Cancer Quality ASSIST (Assessing Symptoms Side Effects and Indicators of Supportive Treatment) measures. Methods We abstracted data from 719 patients' medical records diagnosed with advanced lung, colorectal, or pancreatic cancer in 2008 over a period of three years or until death who received care in the Veterans Affairs Health System to evaluate the association of palliative care specialty consultation with the quality of supportive care overall and by domain using a multivariate regression model. Results All but 54 of 719 patients died within three years and 293 received at least one palliative care consult. Patients evaluated by a palliative care specialist at diagnosis scored seven percentage points higher overall (P < 0.001) and 11 percentage points higher (P < 0.001) within the information and care planning domain compared with those without a consult. Conclusion Early palliative care specialist consultation is associated with better quality of supportive care in three advanced cancers, predominantly driven by improvements in information and care planning. This study supports the effectiveness of early palliative care consultation in three common advanced cancers within the Veterans Affairs Health System and provides a greater understanding of what care processes palliative care teams influence.

KW - Advanced cancer

KW - palliative care

KW - quality

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U2 - 10.1016/j.jpainsymman.2016.04.005

DO - 10.1016/j.jpainsymman.2016.04.005

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AN - SCOPUS:84994496428

SN - 0885-3924

VL - 52

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JO - Journal of Pain and Symptom Management

JF - Journal of Pain and Symptom Management

IS - 4

ER -

Palliative Care Specialist Consultation Is Associated With Supportive Care Quality in Advanced Cancer

Abstract

Keywords

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