Timing of referral to outpatient palliative care for patients with haematologic malignancies

Abstract

Summary Outpatient palliative‐care facilitates timely supportive‐care access; however, there is a paucity of studies on the timing of referral in the outpatient setting for patients with haematologic malignancy. We examined the trend in timing of outpatient palliative‐care referrals over a 10‐year period in patients with haematologic malignancies at our comprehensive cancer centre. We included consecutive patients with a diagnosis of haematologic malignancy who were seen at our outpatient palliative‐care clinic between 1 January 2010 and 31 December 2019. We collected data on patient characteristics, symptom burden and supportive‐care interventions at outpatient palliative‐care consultation. The primary outcome was time from outpatient palliative‐care consultation to death or last follow‐up. In all, 384 patients were referred by leukaemia (n = 143), lymphoma (n = 213), and stem cell transplant (n = 28) services. The median time from outpatient palliative‐care referral to death was 3.4 years (IQR 2.4–5.3) with a significant increase in both the number of referrals per year (p = 0.047) and the timing of referral between 2010 and 2019 (p = 0.001). Patients with haematologic malignancies were referred in a timely fashion to our outpatient palliative‐care clinic, with earlier and greater numbers of referrals over time.

A multicentre survey on the perception of palliative care among health professionals working in haematology

“…The literature contains evidence that a shared path between PC and aggressive curative treatment (such as conditioning chemotherapy and related transplantation) is possible at the same time, accepted by patients, and has positive outcomes [ 32 , 33 ]. An outpatient observational study of patients with acute myeloid leukaemia revealed that those who received early palliative supportive care had a greater quality of life and lower rates of treatment aggressiveness at the end of life [ 34 ].…”

Value of embedded palliative care: outpatient palliative care and health care utilization for patients with hematologic malignancies

“…In conclusion, longitudinal outpatient PC for people with hematologic malignancies is feasible and has benefits upstream from the end-of-life period. 17 Large, multisite, and controlled trials are needed to confirm our findings and determine which aspects of PC are most impactful.…”

A multicenter survey on the perception of palliative care among the health professionals working in hematology

“…There is evidence in the literature that a shared path between PCs, simultaneously with aggressive treatments and related transplantation with curative intent, is feasible and accepted by patients and with positive results [32,33]. An observational outpatient study based on patients with acute myeloid leukemia shows that those who received early palliative supportive care demonstrated a better quality of life and low rates of treatment aggressiveness at the end of life [34].…”