A Randomized Trial of a Nurse-Led Palliative Care Intervention for Patients with Newly Diagnosed Lung Cancer

Reinke, Lynn F.; Sullivan, Donald R.; Slatore, Christopher G.; Ruedebusch, Susan; Smith, Patti; Rise, Peter; Tartaglione, Erica V.; Vig, Elizabeth K.; Au, David H.

doi:10.1089/jpm.2022.0008

Cited by 11 publications

(33 citation statements)

References 28 publications

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“…These domains were selected based on results from the pilot study 8 to best meet the needs of veterans recently given a diagnosis of lung cancer (Table 1.) Three domains, namely, cultural aspects , spiritual aspects , and care of the imminently dying , were not included in the intervention because the inclusion criteria enrolled patients with any stage of lung cancer in an effort to integrate palliative care more upstream 9 ; thus, patients were not imminently dying. Intervention activities that fell under the provision of structure and processes of care domain included documenting the details and outcomes of each study call.…”

Section: Methodsmentioning

confidence: 99%

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Nurse-Led, Telephone-Based Primary Palliative Care Intervention for Patients With Lung Cancer

Reinke,

Tartaglione,

Ruedebusch

et al. 2023

J Hosp Palliat Nurs

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Palliative care is traditionally delivered by specialty-trained palliative care teams. Because of a national workforce shortage of palliative care specialists, there is an urgent need to explore alternative models of palliative care delivery to meet the needs of patients living with serious illness. As part of a multisite randomized controlled trial, 2 registered nurses without previous palliative care experience were trained to deliver a primary palliative care intervention to patients with newly diagnosed lung cancer. The intervention focused on assessing and managing symptoms, psychosocial needs, education, and initiating goals-of-care discussions. The primary outcome, improved symptom burden and quality of life, was not statistically significant. Despite this finding, nurses addressed 5 of the 8 National Consensus Project Guidelines domains of quality palliative care: structure and processes of care; physical, psychological, and social aspects of care; and ethical and legal aspects. Patients' engagement in goals-of-care discussions, a measure of high-quality palliative care, increased. Clinical recommendations offered by the nurses to the patients' clinicians were addressed and accepted on a timely basis. Most patients rated satisfaction with the intervention as “very or extremely” satisfied. These findings may inform future nurse-led palliative care interventions on the specific quality domains of palliative care.

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Section: Methodsmentioning

confidence: 99%

“…Three domains were not core components of the intervention: cultural aspects , spiritual aspects , and care of the imminently dying . The study protocol, intervention, and primary results have been previously reported 8,9 …”

mentioning

confidence: 99%

Nurse-Led, Telephone-Based Primary Palliative Care Intervention for Patients With Lung Cancer

Reinke,

Tartaglione,

Ruedebusch

et al. 2023

J Hosp Palliat Nurs

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“…Nurse scientists should also continue to develop protocols and interventions that are nurse-led to facilitate easier access to palliative care resources. Nurse-led protocols have been developed for various specific disease processes, 34,35 but not in a significant way for veterans.…”

Section: Journal Ofmentioning

confidence: 99%

Coming to Terms

Varilek,

Isaacson

2024

J Hosp Palliat Nurs

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Female veteran populations are growing internationally and are more likely than men to develop certain serious illnesses, including some cancers. In the United States, fewer than 50% of eligible female veterans sought care at Veteran Affairs facilities. In addition, female veterans are not well represented within palliative care research, and little research exists that explores the female veteran experience of living with a serious illness. The purpose of this study was to explore female veterans' experiences of living with a serious illness. This study reports the qualitative findings from a multimethod study using qualitative inquiry to explore female veterans' experiences of living with a serious illness. Participants completed individual, semistructured interviews. Braun and Clarke's method of reflexive thematic analysis guided the analysis. Ten participants shared their experiences, and 3 themes emerged: “You call this quality of life?”, coming to terms, and “it” dictates everything. This study highlights the impaired quality of life of female veterans. Palliative care can serve to improve quality of life and return a sense of control back to female veterans. Nurses at all levels can have a positive impact in improving palliative care delivery for the female veteran population in both civilian and government health care sectors.

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“…Additionally, patient identification, structure, and operational aspects of these programs have not been well described, making program replication challenging. One study of a nurse-led telephonic program for patients with lung cancer at any stage in the Veterans Affairs system did not show benefit, calling into question which patients may benefit from early access to services [59]. A large Patient-Centered Outcome Research Institute (PCORI) funded trial is currently underway to answer these questions as it compares nurse-led telephonic care to traditional clinic-based palliative care for patients with serious illness randomized after an ED visit [52].…”

Section: Barriersmentioning

confidence: 99%

“…A large Patient-Centered Outcome Research Institute (PCORI) funded trial is currently underway to answer these questions as it compares nurse-led telephonic care to traditional clinic-based palliative care for patients with serious illness randomized after an ED visit [52]. Reimbursement is undeveloped, although some programs have been funded by insurers and/or health systems, and the Centers for Medicare & Medicaid Services (CMS) provided reimbursement for virtual physician telehealth during the COVID-19 pandemic [59].…”

Section: Barriersmentioning

confidence: 99%

Palliative care models for patients living with advanced cancer: a narrative review for the emergency department clinician

et al. 2022

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Eighty-one percent of persons living with cancer have an emergency department (ED) visit within the last 6 months of life. Many cancer patients in the ED are at an advanced stage with high symptom burden and complex needs, and over half is admitted to an inpatient setting. Innovative models of care have been developed to provide high quality, ambulatory, and home-based care to persons living with serious, life-limiting illness, such as advanced cancer. New care models can be divided into a number of categories based on either prognosis (e.g., greater than or less than 6 months), or level of care (e.g., lower versus higher intensity needs, such as intravenous pain/nausea medication or frequent monitoring), and goals of care (e.g., cancer-directed treatment versus symptom-focused care only). We performed a narrative review to (1) compare models of care for seriously ill cancer patients in the ED and (2) examine factors that may hasten or impede wider dissemination of these models.

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A Randomized Trial of a Nurse-Led Palliative Care Intervention for Patients with Newly Diagnosed Lung Cancer

Cited by 11 publications

References 28 publications

Nurse-Led, Telephone-Based Primary Palliative Care Intervention for Patients With Lung Cancer

Nurse-Led, Telephone-Based Primary Palliative Care Intervention for Patients With Lung Cancer

Coming to Terms

Palliative care models for patients living with advanced cancer: a narrative review for the emergency department clinician

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