Purpose Integration of palliative care into oncology practice remains suboptimal. Misperceptions about the meaning of palliative care may negatively impact utilization. We assessed whether the term and/or the description of palliative care services affected patient views. Methods 2×2 between-subject randomized factorial telephone survey of 169 patients with advanced cancer. Patients were randomized into 1 of 4 groups that differed by name (supportive care vs. palliative care) and description (patient-centered vs. traditional). Main outcomes (0–10 Likert scale) were patient understanding, impressions, perceived need, and intended use of services. Results When compared to palliative care, the term supportive care was associated with better understanding (7.7 vs. 6.8; p=0.021), more favorable impressions (8.4 vs. 7.3; p=0.002), and higher future perceived need (8.6 vs. 7.7; p=0.017). There was no difference in outcomes between traditional and patient-centered descriptions. In adjusted linear regression models, the term supportive care remained associated with more favorable impressions (p=0.003) and higher future perceived need (p=0.022) when compared to palliative care. Conclusions Patients with advanced cancer view the name supportive care more favorably than palliative care. Future efforts to integrate principles of palliative medicine into oncology may require changing impressions of palliative care or substituting the term supportive care.

Background: It is not known whether unmet palliative care needs are associated with an interest in palliative care services among patients with advanced cancer receiving ongoing oncology care. Objective: To assess the association between unmet palliative care needs and patient interest in subspecialty palliative care services. Design: Cross-sectional telephone survey. Subjects and setting: One hundred sixty-nine patients with advanced cancer receiving care from 20 oncologists at two academic cancer centers. Measurements: Surveys assessed palliative care needs in six domains. Patients were read a description of palliative care and then asked three questions about their current interest in subspecialty palliative care services (perceived need, likelihood of requesting, willingness to see if their oncologist recommended; all outcomes on 0-10 Likert scale). Results: The vast majority of patients described unmet palliative care needs, most commonly related to psychological/emotional distress (62%) and symptoms (62%). In fully adjusted models accounting for clustering by oncologist, unmet needs in these domains were associated with a higher perceived need for subspecialty palliative care services (psychological/emotional needs odds ratio [OR] 1.30; 95% confidence interval [CI] 1.06-1.58; p = 0.01; symptom needs OR 1.27; 95% CI 1.01-1.60; p = 0.04). There was no significant association between unmet needs and likelihood of requesting palliative care services. Willingness to see palliative care if oncologist recommended was high (mean 8.6/10, standard deviation [SD] 2). Conclusion: Patients with advanced cancer and unmet symptom and psychological/emotional needs perceive a high need for subspecialty palliative care services but may not request them. Efforts to increase appropriate use of subspecialty palliative care for cancer may require oncologist-initiated referrals.

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