Results of an educational tool for residents and referring physicians on palliative radiation for bone metastases.

Authors

null

Nina Desai

Medical College of Wisconsin, Milwaukee, WI

Nina Desai, Malcolm David Mattes, Eric Bonar, Grant Robertson, Candice Aitken Johnstone

Organizations

Medical College of Wisconsin, Milwaukee, WI, West Virginia University, Morgantown, WV, Froedtert and the Medical College of Wisconsin, Milwaukee, WI

Research Funding

Other

Background: Palliative radiation therapy (RT) for painful bone metastases is underutilized in the United States (U.S.), perhaps due to inappropriate use of multi-fraction (MF) regimens over more convenient, less costly, and equally effective single fraction (SF) regimens. Practice patterns may change with improved knowledge of radiation oncology residents (ROR) and non-radiation oncology physicians who refer patients for palliative RT. The aim of this study was to provide evidence-based educational content to these groups, and assess knowledge and views before and after. Methods: In April - June 2017, an electronic educational tool was sent to medical oncology and palliative care physicians, and ROR in the U.S. Multiple choice questions assessed knowledge, and were followed by evidence supporting the correct answer. Likert and sliding scales gaged tool impact. Chi-square and Mann-Whitney tests compared groups and pre/post-test responses. Results: Responses were obtained from 109 (2%) referring physicians (RP) and 135 (21%) ROR. ROR had higher scores than RP for 8 of 9 objective questions. RP were less likely to know that SF and MF are equivalent in terms of pain response (64 v. 91%, p < 0.01) and subsequent analgesic use (86 v. 95%, p = 0.02), or that SF is associated with a higher retreatment rate (27 v. 93%, p < 0.01). ROR were less likely to know that SF and MF are equivalent for patients with a high likelihood of long term survival (25 v. 56%, p < 0.01). After viewing the content, ROR felt more knowledgeable [mdn 3 (IQR 3 - 4) v. 4 (IQR 3 - 4), p < 0.01], and RP felt more empowered [mdn 3 (IQR 2 - 4) v. 4 (IQR 3 - 4), p < 0.01]. RP found the survey more helpful, and knew less of the data prior [mdn 50 (IQR 25 - 75%) v. 80% (IQR 66.3 - 90%), p < 0.01]. Despite knowing the data, ROR preferred SF less than RP at completion (67 v. 85%, p < 0.01). Conclusions: This study demonstrates a need for educational content for multidisciplinary providers on appropriate palliation of bone metastases. Despite ample knowledge, the bias of practicing radiation oncologists for MF is being passed onto residents. Greater knowledge may translate into more effective referral patterns and patient advocacy by RP, and potentially improve utilization of palliative RT in the U.S.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2018 Palliative and Supportive Care in Oncology Symposium

Session Type

Poster Session

Session Title

Poster Session A: Communication and Shared Decision Making; Integration and Delivery of Palliative and Supportive Care; and Psychosocial and Spiritual/Cultural Assessment and Management

Track

Integration and Delivery of Palliative and Supportive Care,Communication and Shared Decision Making,Psychosocial and Spiritual/Cultural Assessment and Management

Sub Track

Integration and Delivery of Palliative and Supportive Care

Citation

J Clin Oncol 36, 2018 (suppl 34; abstr 82)

DOI

10.1200/JCO.2018.36.34_suppl.82

Abstract #

82

Poster Bd #

C2

Abstract Disclosures

Similar Abstracts

First Author: Nina Desai

Abstract

2016 Palliative and Supportive Care in Oncology Symposium

Development and implementation of a clinical pathway for radiation of bone metastases on a palliative radiation oncology service.

First Author: Lisa Rotenstein

First Author: Natalia Simon

Abstract

2017 Palliative and Supportive Care in Oncology Symposium

Impact of a clinical pathway tool on appropriate palliative radiation therapy for bone metastases.

First Author: Lisa Rotenstein