Models of supportive care in oncology

Abstract

Purpose of reviewSupportive care services have evolved overtime to meet the growing supportive care need of patients with cancer and their families. In this review, we summarize existing definitions of supportive care, highlight empiric studies on supportive care delivery, and propose an integrated conceptual framework on supportive cancer care. Recent findingsSupportive care aims at addressing the patients' physical, emotional, social, spiritual, and informational needs throughout the disease trajectory. Interdisciplinary teams are needed to deliver multidimensional care. Oncology teams have an important role providing supportive care in the front lines and referring patients to supportive care services such as palliative care, social work, rehabilitation, psycho-oncology, and integrative medicine. However, the current model of as needed referral and siloed departments can lead to heterogeneous access and fragmented care. To overcome these challenges, we propose a conceptual model in which supportive care services are organized under one department with a unified approach to patient care, program development, and research. Key features of this model include universal referral, systematic screening, tailored specialist involvement, streamlined care, collaborative teamwork, and enhanced outcomes. SummaryFurther research is needed to develop and test innovative supportive care models that can improve patient outcomes.

Missing in Action: Reports of Interdisciplinary Integration in Canadian Palliative Care

“…Even within provinces, there was variation based on these individual differences of respondents, which perhaps speaks to the myriad of factors involved in trying to coordinating effective integrated palliative care and that each region may need its own specific solutions. However, as Hui et al discusses, interdisciplinary teams create multidimensional care that address a patients’ physical, emotional, social, spiritual, and informational needs [ 33 ]. Without complete interdisciplinary teams, patients receive fragmented care.…”

Barriers to and facilitators of implementation of the integration of oncology and palliative care in daily practice: a systematic review

“…Our results also demonstrate the importance of developing an effective and implementable care delivery model for IOP. Various care delivery models have been proposed, but standardization remains to be achieved [20,21,42,43]. In a clinical trial by Temel et al, a landmark study, a specialized PC team conducted symptom relief, treatment goal setting and decision support, care coordination, and so on at least once a month.…”

“…Care delivery evaluates various aspects of the clinical environment at multiple levels, such as clinical resources, costs, regional alliances, medical insurance systems, policies, and administrative projects, in addition to issues regarding healthcare professionals (HCPs) and institutional stakeholders [19]. Previous studies have described several levels of barriers to IOP, for example, misconceptions or fear related to PC and the lack of a standardized care delivery pathway; there are concerns that HCPs, patients, hospital stakeholders, and policymakers are facing challenges around IOP implementation in daily practice [20][21][22][23][24][25][26][27]. However, to date, the barriers to and facilitators of IOP as regards cancer care delivery have not been comprehensively classi ed across multiple levels.…”

Palliative and prognostic approach in cancer patients identified in the multicentre NECesidades PALiativas 2 study in Argentina

“…Early identification of palliative care (PC) needs has proven benefits in quality of life, survival and decision-making [ 1 ]. However, the current PC model of as-needed referral and siloed departments can lead to heterogeneous access and fragmented care [ 2 ]. Furthermore, while integrated PC delivery gradually increases in the last year of life, disease-modifying and potentially curative care and unplanned care are not decreasing.…”

“…In Argentina, only 10% of patients with PC needs have accessibility to PC services [ 12 , 13 ]. In addition, the early palliative approach can prevent or ameliorate suffering and must be an informed option and available for all [ 2 , 6 , 14 ]. Therefore, we hypothesised that the timely identification supported by a predictive mortality risk model would be necessary for PC National Programme Design in Argentina [ 3 , 15 ].…”