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Models of Integration of Specialized Palliative Care with Oncology

Authors
  • Mathews, Jean1, 2
  • Hannon, Breffni1, 2, 2
  • Zimmermann, Camilla1, 2, 2
  • 1 Princess Margaret Cancer Centre, University Health Network, 610 University Ave., 16-712, Toronto, Ontario, M5G 2M9, Canada , Toronto (Canada)
  • 2 University of Toronto, Toronto, Canada , Toronto (Canada)
Type
Published Article
Journal
Current Treatment Options in Oncology
Publisher
Springer US
Publication Date
Apr 08, 2021
Volume
22
Issue
5
Identifiers
DOI: 10.1007/s11864-021-00836-1
Source
Springer Nature
Keywords
License
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Abstract

Evidence from randomized controlled trials and meta-analyses has shown that early integration of specialized palliative care improves symptoms and quality of life for patients with advanced cancer. There are various models of early integration, which may be classified based on setting of care and method of palliative care referral. Most successful randomized controlled trials of early palliative care have used a model of specialized teams providing in-person palliative care in free-standing or embedded outpatient clinics. During the COVID-19 pandemic, telehealth has become a prominent model for palliative care delivery. This model of care has been well received by patients and palliative care providers, although evidence to date is limited. Despite evidence from trials that routine early integration of palliative care into oncology care improves patient outcomes, referral to palliative care still occurs mostly according to the judgment of individual oncologists. This hinders equitable access to palliative care and to its known benefits for patients and their caregivers. Automated referral based on triggering criteria is being actively explored as an alternative. In particular, routine technology-assisted symptom screening, combined with targeted needs-based automatic referral to outpatient palliative care, may improve integration and ultimately increase quality of life.

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