Conference Coverage

Study reveals barriers to accessing palliative care services


 

Kathryn Hutchins

©ASCO/Todd Buchanan 2016

SAN FRANCISCO—Patients may face challenges when trying to access palliative and supportive care services at cancer centers, a new study suggests.

Researchers took a “mystery shopper” approach and placed calls to cancer centers inquiring about palliative and supportive care services for a family member.

The callers sometimes had difficulty obtaining information about these services, even though all of the centers offer them.

“It’s sobering to hear that such services are not readily accessible at many centers,” said study investigator Kathryn Hutchins, a medical student at Duke University in Durham, North Carolina.

“However, it provides an opportunity for cancer centers to empower their front-line staff, as well as the oncology care team, through education and training so that the entire enterprise has a common understanding of palliative care and how to access it.”

Hutchins and her colleagues presented this research at the 2016 Palliative Care in Oncology Symposium (abstract 122).

The researchers placed 160 calls to 40 major cancer centers. The team chose to focus on National Cancer Institute-designated cancer centers because they all provide palliative care services along with other supportive care services.

The researchers used the same script for every call, asking about services for a 58-year-old female who was recently diagnosed with inoperable liver cancer. The team called each center 4 times on different days.

In 38.2% of the calls, the researchers were not able to receive complete information about supportive care services.

In 9.5% of calls, cancer center staff gave an answer other than “yes” regarding the availability of palliative care services, even though such services were available.

The answers varied and included responses such as:

  • Palliative care was for end-of-life patients only (n=2)
  • No physicians specialized in symptom management (n=3)
  • A medical record review would be needed first (n=2).

In addition, 10 staff members said they were unsure about the availability of palliative care, and 2 were unfamiliar with the term.

Overall, 37.6% of the callers were told that all 7 supportive care services they inquired about were offered.

“As oncologists, we like to believe that, when we refer patients to our institution’s helpline, they will get connected to the services they need, but that doesn’t always happen,” said study investigator Arif Kamal, MD, of Duke Cancer Institute.

“It’s important for oncologists to be aware of these barriers and to work to eliminate them.”

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