Palliative care of patients with haematological malignancies: strategies to overcome difficulties via integrated care

Wedding, Ulrich

doi:10.1016/s2666-7568(21)00213-0

Cited by 21 publications

(27 citation statements)

References 61 publications

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“…In contrast with HMs, the trajectory of disease in solid tumours is relatively predictable, with metastasis generally heralding incurability and a steady downward trajectory (Figure 2). Previous publications have described the characteristics of various types of HM with respect to PC needs 24,25 . We find it helpful to divide HMs into three main groups based on the trajectory of disease, setting of care and challenges to PC delivery.…”

Section: Pc In Hmmentioning

confidence: 99%

“…While oncologists may see their patients every 3 months, the dynamic character of many HM necessitate visits at shorter time intervals as well as treatment of multiple acute life‐threatening events, commonly with prolonged periods of inpatient treatment. It may be argued that this intense and intimate relationship may result in difficulty for both patient and haemato‐oncologist in referral to PC 24,49 . Therefore, haemato‐oncologists may be more inclined to refer to PC if they can maintain clinic visits with their patients 65 …”

Section: Barriers To the Integration Of Pc In Hmmentioning

confidence: 99%

“…Not only is the EOL more complex to predict in haemato‐oncology; even when death becomes a reasonable scenario, haematologists often feel less comfortable discussing death and dying or referring to hospice and are more likely to feel a sense of failure when disease progresses 57 . A previous review reported a large difference in the number of published studies regarding palliative care in solid tumours compared with haematological malignancies 24 . We performed a focused search for the terms ‘palliate’, ‘palliation’ or ‘palliative’ in article titles of the five leading journals in haemato‐oncology and medical oncology, as ranked by journal citation reports, is illustrative of this point (Figure 3).…”

Section: Current State Of Pc Needs In Hmsmentioning

confidence: 99%

“…Previous publications have described the characteristics of various types of HM with respect to PC needs. 24 , 25 We find it helpful to divide HMs into three main groups based on the trajectory of disease, setting of care and challenges to PC delivery. These are described briefly below and are depicted in Figure 2B–D .…”

Section: Pc In Hmmentioning

confidence: 99%

“… 57 A previous review reported a large difference in the number of published studies regarding palliative care in solid tumours compared with haematological malignancies. 24 We performed a focused search for the terms ‘palliate’, ‘palliation’ or ‘palliative’ in article titles of the five leading journals in haemato‐oncology and medical oncology, as ranked by journal citation reports, is illustrative of this point (Figure 3 ). Although the number of publications on PC in leading oncology journals has fluctuated, the percentage of PC publications in these journals has consistently been more than ten‐fold higher than in leading haematology journals.…”

Section: Current State Of Pc Needs In Hmsmentioning

confidence: 99%

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Early integration of palliative care for patients with haematological malignancies

et al. 2022

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Early palliative care (EPC) significantly improves quality of life, symptoms, and satisfaction with care for patients with advanced cancer. International organizations have recognized and promoted the role of palliative care as a distinct specialty, advocating its involvement throughout the cancer trajectory. Although patients with haematologic malignancies (HMs) have a comparable symptom burden to patients with solid tumours, they face multiple barriers to EPC integration. In this review, we discuss these barriers, present updated evidence from clinical trials of EPC in HMs and propose models to support EPC integration into care for patients with HMs.

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Section: Pc In Hmmentioning

confidence: 99%

Section: Barriers To the Integration Of Pc In Hmmentioning

confidence: 99%

Section: Current State Of Pc Needs In Hmsmentioning

confidence: 99%

Section: Pc In Hmmentioning

confidence: 99%

Section: Current State Of Pc Needs In Hmsmentioning

confidence: 99%

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Early integration of palliative care for patients with haematological malignancies

et al. 2022

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Haematological nurses' experiences about palliative care trajectories of patients with life‐threatening haematological malignancies: A qualitative study

et al. 2022

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Aims To explore haematological nurses' experiences about the palliative care trajectories of patients with life‐threatening haematological malignancies. Design A qualitative study with a descriptive and explorative design. Methods Data were collected through 12 individual semi‐structured interviews of nurses who work with patients with haematological malignancies from four hospitals in Norway. The data were analysed using systematic text condensation. The study was reported according to the Consolidated Criteria for Reporting Qualitative Research checklist. Results Three categories emerged from the data analysis: focus on a cure delays integration of palliative care, dialogue with patients facilitates palliative care and the need for enhanced interdisciplinary understanding. Patient or public contribution No patient or public contribution since nurses' experiences were explored.

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Palliative care for patients with hematologic malignancies in Germany: a nationwide survey on everyday practice and influencing factors from the perspective of treating physicians

Gebel,

Kruschel,

Bodinger

et al. 2024

Ann Hematol

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Integrating palliative care into the treatment of patients with advanced hematological malignancies (HM) remains challenging. To explore treating physicians’ perspectives on current palliative care practice and to evaluate factors influencing integration, we conducted a nationwide online survey. Based on literature and expert review, the survey addressed the importance of palliative care, communication about life-threatening conditions, challenges in establishing goals of care, and factors influencing the integration of palliative care. 207 physicians treating patients with HM in Germany participated. We used standard descriptive statistics to analyze quantitative data and a content structuring approach. Most physicians considered palliative care in HM to be very important (60.6%) and discussed life-threatening conditions with more than half of their patients (52%), especially when goals of care were changed (87.0%) or when patients raised the topic (84.0%). Disease-related factors, different professional perspectives on prognosis, and patient hopes were the main barriers to changing goals of care, but collaboration with colleagues and multidisciplinary teams provided important support. Time constraints were identified as the main barrier to integrating palliative care. The majority worked well with palliative care teams. Referral processes and conditions were perceived as minor barriers. The study highlights the need to address barriers to integrating palliative care into the management of patients with advanced HM. Future research should aim at optimizing palliative care for patients with HM.

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Palliative care of patients with haematological malignancies: strategies to overcome difficulties via integrated care

Abstract: This is the fourth in a Series of five papers about haematological malignancies in older people (papers 1 and 3 appear in The Lancet Haematology)For the Haematological malignancies in older people Series see https://www.thelancet. com/series/haematologicalmalignancies-in-older-people

Cited by 21 publications

References 61 publications

Early integration of palliative care for patients with haematological malignancies

Early integration of palliative care for patients with haematological malignancies

Haematological nurses' experiences about palliative care trajectories of patients with life‐threatening haematological malignancies: A qualitative study

Palliative care for patients with hematologic malignancies in Germany: a nationwide survey on everyday practice and influencing factors from the perspective of treating physicians

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