Hospitalized Patients With Cancer Often Not Receiving Adequate Inpatient Support, Palliative Care

06/08/18

Palliative care interventions and inpatient support may be inadequate among hospitalized patients with solid and hematologic cancers, according to a presentation at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting (June 1-5; Chicago, IL).

This trend remains constant regardless of disease curability, researchers noted.

While inpatient supportive care interventions are often targeted to patients with advanced solid tumors because of perceived higher symptom burden, limited studies have attempted to characterize symptom prevalence in hospitalized patients with curable cancers.

Richard Newcomb, MD, Massachusetts General Hospital, and colleagues conducted a study to describe and compare symptom burden and palliative care utilization in hospitalized patients with curable and incurable cancers in order to determine the allocation of such supportive care resources. The single center study assessed 1549 patients—238 of whom with hematologic cancers, 239 with curable solid cancers, 123 with incurable hematologic cancers, and 949 with incurable solid cancers—who experienced an unplanned hospitalization from 2014 through 2017. Researchers assessed patient physical symptoms and psychological distress upon admission.

Dr Newcomb and colleagues reported the median number of moderate-to-severe symptoms reported by patients with curable hematologic, curable solid, incurable hematologic, and incurable solid cancers were 5, 5, 5, and 6, respectively. A majority of patients in each group reported moderate-to-severe fatigue (83.6%, 82.9%, 81.3%, and 86.9%, respectively). Researchers also noted significant rates of depression, anxiety, and post-traumatic stress disorder in all patient groups.

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Furthermore, Dr Newcomb and colleagues disclosed that among the patients in the top quartile of symptom burden of each disease group, palliative care was consulted in 16.2%, 7.9%, 23.8%, and 49.6%, respectively.

Results of the study led researchers to conclude that hospitalized patients with solid and hematologic cancers experience substantial physical and psychological symptoms, regardless of the curability of their disease. Importantly, palliative care is not often consulted for highly symptomatic patients with curable disease. “Inpatient supportive care interventions should target the needs of all highly symptomatic patients with cancer,” they concluded.—Zachary Bessette