Palliative care education and research at US cancer centers: A national survey

Abstract

BACKGROUND: Palliative care (PC) education and research are essential to developing a skilled workforce and evidence base to support the delivery of quality cancer care. The current state of PC education and research at US cancer centers is unclear. In this national survey, the education and research programs of the National Cancer Institute (NCI)-designated and nondesignated cancer centers and the changes between 2009 and 2018 are compared. METHODS: Between April and August 2018, PC program leaders at all NCI-designated cancer centers and a random sample of nondesignated centers were sent a survey to examine the structure, processes, and outcomes of their programs on the basis of questions from a 2009 national survey. This preplanned analysis focused on education and research. RESULTS: There were 52 of 61 (85%) NCI-designated and 27 of 38 (71%) nondesignated cancer centers that responded. NCI-designated centers were more likely than nondesignated centers to have a PC fellowship program (87% vs 30%; P < .001), training for advanced practice providers (71% vs 44%; P = .03), PC research program (58% vs 15%; P < .001), peer-reviewed funding (43% vs 11%; P = .005), and philanthropic grants (41% vs 7%; P = .002). There were few significant improvements in PC education or research between 2009 and 2018 for both groups, notable exceptions include an increase in PC fellowships (38% vs 87%; P < .001) and mandatory PC rotations for medical oncology fellows (29% vs 55%; P = .02) at NCI-designated cancer centers. CONCLUSIONS: PC education and research are more developed at NCI-designated cancer centers. Despite some progress over the past decade, it is relatively slow and suboptimal.

Timely Palliative Care: Personalizing the Process of Referral

“…Another system barrier to timely palliative care referral is the limited palliative care program infrastructure. A 2019 national survey of US cancer centers revealed that many palliative care programs are still under-developed due to lack of resources [ 46 , 68 , 69 ]. Although 95% of National Cancer Institute (NCI)-designated cancer centers had outpatient clinics, only 40% of non-NCI designated cancer centers reported having these services available [ 69 ].…”

Evolution of Oncology and Palliative Nursing in Meeting the Changing Landscape of Cancer Care

“…The palliative care improves the outcomes of caregivers and helps in reducing the adverse sides of chemotherapeutics at the terminal stage of cancer [ 36 , 38 – 41 ]. In the light of these outcomes, palliative care nursing models have been developed and applied in a large number of cancer hospitals and oncology care centres around the globe [ 42 , 43 ], but even though with huge benefits and paramount understanding only a small number of cancer patients are integrated for palliative care and those are often suffering from the late stage of cancer [ 44 ]. The lack of feasible palliative care services and care models is a great challenge for both inpatients and outpatients [ 44 ].…”

Inpatient Palliative Care Is Less Utilized in Rare, Fatal Extrahepatic Cholangiocarcinoma: A Ten-Year National Perspective

“…Governments should identify policies for the promotion of palliative care, including workforce growth, payment reform, enhancing public awareness, as well as research grants. Since the benefits of palliative care are becoming more obvious in recent years, and with increasing numbers of grants and incentives [ 33 ], it is anticipated that palliative care utilization for all eligible patients will be increased in upcoming years—though it still might be suboptimal.…”