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Advance care planning with completion of POLST forms compared with ADs in patients with advanced cancer was associated with two quality end-of-life care metrics: OHD and hospice admission. Our study suggests that goals-of-care discussions including POLST form completion may improve end-of-life care for patients with advanced cancer.

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Objectives Discuss Advance Care Planning approaches used by cardiovascular disease decedents in a nationally representative sample. Identify significant symptoms experienced in the last year of life for decedents of cardiovascular disease. Describe the association of symptom burden with the proclivity to engage in advance care planning in individuals dying of cardiovascular disease. Original Research Background. The unpredictable disease trajectory for persons dying from cardiovascular disease (CVD) may make planning for future care challenging. In addition, research suggests these individuals may suffer with significant symptomatology in late life. Research Objectives. To describe symptom burden and advance care planning (ACP) in individuals dying of CVD, and examine the association between symptom burden and ACP in this population.

8557 Background: Surveillance imaging with computerized tomography (CT) and positron emission tomography with CT (PET/CT) scans during follow-up after first-line therapies in patients with non-Hodgkin lymphoma (NHL) is commonly used in practice. However, most guidelines do not recommend surveillance imaging. We aimed to determine the value of routine imaging for the detection of first relapse in NHL patients in complete remission (CR) after first-line therapies. Methods: We retrospectively analyzed NHL patients referred to our center, who achieved CR after first-line therapies and subsequently relapsed. We evaluated whether the relapse was detected solely by routine CT or PET/CT or by patient-reported symptoms. Subgroup analysis was performed according to baseline histology (indolent vs. aggressive NHL). Data were also collected to determine the number of additional imaging, number of false positive scans, invasive procedures and iatrogenic complications, directly resulting from an abnormality detected on surveillance imaging. Results: Seventy-seven patients with first relapse of NHL between January 1, 2000 and December 31, 2010 were included. Majority of the relapses were detected by patient-reported symptoms as opposed to surveillance imaging (79.2% (n=61) vs. 20.8% (n=16); p<0.0001). There was no overall survival difference between the two groups (p=0.08). Patient-reported symptoms led to the detection of majority of relapses in aggressive (86.4% (n=45) vs. 13.6% (n=6); p<0.0001) and indolent NHL (69.7% (n=32) vs. 30.3% (n=10); p=0.037). There were greater number of scans done after a suspected relapse in the imaging versus symptoms group (1.94 versus 0.97; p=0.0004). Surveillance imaging led to 2 false positive scans/invasive procedures with one case of iatrogenic pneumothorax. Conclusions: Our limited retrospective analysis suggests that there is a limited role of surveillance imaging by CT or PET/CT for the detection of relapse in patients with NHL. There was no difference in survival outcome in our study between the two groups.

181 Background: Decreasing 30-day hospital readmissions is an important quality care measure and signifies high-quality care. This study seeks to identify the benefits of Supportive Care consultations on 30-day readmissions to oncology inpatient services in an academic hospital. Methods: A retrospective review of all patients that had at least one 30-day readmission to the medical oncology or hematological malignancy service during a 2 year period (2011-2012). Data was collected on age, sex, cancer type, stage, number of readmissions, and presence of inpatient Supportive Care consultation. Results: During the study period 410 patients were identified with at least one 30-day readmission to an oncology service. Patients with a supportive care consult, 111 (27.7%), had an average of 2.5 readmissions and patients without a consultation, 299 (72.9%), had an average of 2.0 readmissions (p = 0.014). After Supportive Care consultation a reduction of 0.87 admissions (p < 0.001) was observed. Stage IV disease was observed in 203 (49.5%) of patients studied. Conclusions: Supportive Care is often consulted for patients with significant symptoms and suffering during advanced illness. The higher observed average readmissions in patients seen by Supportive Care may reflect the complex assistance needed by this patient population. This study demonstrates a benefit of Supportive Care consultation in reducing 30-day readmissions after consultation.

e18183 Background: Social media encompasses a wide variety of web based and mobile technologies. It has become increasingly popular, allowing for rapid communication and dissemination of information. Many believe that social media can be used as a platform for patient education and knowledge sharing. This survey intended to assess patient use of social media and patient expectations for its role at our cancer center. Methods: The study took place at West Virginia University (WVU) Hospital/Mary Babb Randolph Cancer Center, a tertiary care center. This IRB-approved, anonymous, and voluntary survey included twenty-five questions that abstracted patient data which included: age, gender, cancer type, level of education, internet use, information sources for given cancer, use of social media, and the use of WVU cancer website and social media. The survey was distributed by nursing staff to patients who were at least 18 years of age Results: 370 surveys were collected in total. 87.6 % of patients reported using social media, with Facebook as the most commonly used platform at 85.6 %. 70% reported to view or update social media sites daily. All patients reported at least monthly internet use with 61.1 % of patients reported using the internet daily. 32.7% of patients interact with WVU Cancer Centeron social media daily. When asked how patients search for background information or reviews about their provider, 57.8% of patients reported they used our institution’s website. 55.7% of patients believe it would beneficial to contact their cancer provider through social media. Only 22% of patients reported they use social media for medical information. Conclusions: With the increasing use of social media for medical information over the past several years, it is crucial for academic centers and providers to keep up with the growing demand to provide accurate and practical information for patients. Our data suggests our patient population would like to see an increased use of social media from the cancer center and its providers. The information can be used to update our cancer website and social media sites to provide patient-centered cancer information in hopes that patients will have one reliable source for all of their disease related questions and concerns.