Palliative specialty care availability for adults in community oncology practices.

Authors

Tiffany Statler

Tiffany M. Statler

Atrium Health Wake Forest Baptist, Winston Salem, NC

Tiffany M. Statler , Emily Van Meter Dressler , Heidi D. Klepin , Kathryn E. Weaver , Jennifer Gabbard

Organizations

Atrium Health Wake Forest Baptist, Winston Salem, NC, Wake Forest School of Medicine, Winston-Salem, NC, Wake Forest Baptist Comprehensive Cancer Center, Winston Salem, NC

Research Funding

U.S. National Institutes of Health

Background: The American Society of Clinical Oncology recommends integration of palliative care in patients with advanced cancer. Studies have shown the availability of palliative care services, especially in outpatient settings, varies widely across practice sites; factors associated with outpatient palliative care clinic availability remain unknown. Our study describes the presence and characteristics of palliative care resources in community oncology practices. Methods: Analyses used data from the 2015 Cancer Care Delivery Research (CCDR) Landscape Assessment of National Cancer Institute Community Oncology Research Program (NCORP) practices (funding support provided by 2UG1CA189824). Oncology practices were surveyed regarding availability of specialty providers and supportive services, including palliative care, as reported by designated CCDR leads. Descriptive statistics describe availability of providers and services, and logistic regression models identify practice characteristics associated with supportive/palliative care specialist availability. Results: 216 non-pediatric exclusive NCORP practice groups were included in analyses. Characteristics are shown in Table. A majority of practices had palliative care specialists (76%), oncology certified nurses (95%), and advance practice providers (80%); 45% had nurse navigators for oncology. 76% of practices had inpatient palliative care consultation services, but only 36% had a dedicated outpatient palliative care clinic. Multivariable analyses demonstrated practices with Medicaid and/or uninsured patient volumes > 25% (Odds Ratio (OR) = 2.5, p = 0.020), more oncology providers (OR = 1.02, p = 0.025), survivorship clinic availability (OR = 2.5, p = 0.005), and who participated in the Quality Oncology Practice Initiative (QOPI) (OR = 2.0, p = 0.039) were significantly more likely to have an outpatient palliative care clinic. Conclusions: Most community oncology practices reported having palliative care specialists, although only a third had a dedicated outpatient palliative care clinic. Newly discovered factors associated with increased odds of having an outpatient palliative care clinic can inform future efforts to expand the availability of outpatient palliative care clinics within community oncology practices.

NCORP oncology practice characteristics.


N = 216 (%)
Number of adult oncology providers*, median (IQR)
9 (4-18)
Practice ownership type:

Independently owned

Owned by large regional/multistate health system

Other (HMO/payer, publicly or university owned)


56 (26%)

141 (67%)

7 (7%)
Proportion with Medicaid and/or Uninsured populations >25%
41 (20%)
Safety-net hospital
39 (18%)
Availability of palliative care specialists who see oncology patients at/affiliated with site


162 (76%)

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Symptoms and Survivorship

Track

Symptom Science and Palliative Care

Sub Track

Palliative Care and Symptom Management

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr e24110)

DOI

10.1200/JCO.2022.40.16_suppl.e24110

Abstract #

e24110

Abstract Disclosures

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