Referral Patterns of Outpatient Palliative Care among the Head and Neck Cancer Population
Introduction Patients with head and neck cancer (HNC) experience unique physical and psychosocial challenges that impact their health and quality of life. Early implementation of palliative care has been shown to improve various health care outcomes. Objective The aim of the present study...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Revinter Publicações Ltda.
2022-10-01
|
| Series: | International Archives of Otorhinolaryngology |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1741436 |
| _version_ | 1811225929691693056 |
|---|---|
| author | Ari Saravia Keonho Albert Kong Ryan Roy Rachel Barry Christine Guidry Lee S. McDaniel Mary C. Raven Anna M. Pou Ashley C. Mays |
| author_facet | Ari Saravia Keonho Albert Kong Ryan Roy Rachel Barry Christine Guidry Lee S. McDaniel Mary C. Raven Anna M. Pou Ashley C. Mays |
| author_sort | Ari Saravia |
| collection | DOAJ |
| description | Introduction Patients with head and neck cancer (HNC) experience unique physical and psychosocial challenges that impact their health and quality of life. Early implementation of palliative care has been shown to improve various health care outcomes.
Objective The aim of the present study was to evaluate the patterns of referral of patients with HNC to outpatient palliative care as they relate to utilization of resources and end-of-life discussions.
Methods We performed a retrospective review of 245 patients with HNC referred to outpatient palliative care services at two Louisiana tertiary care centers from June 1, 2014, to October 1, 2019. The control group consisted of those that were referred but did not follow-up. Reasons for referral were obtained, and outcome measures such as emergency department (ED) visits, hospital readmissions, and advance care planning (ACP) documentation were assessed according to predictive variables.
Results There were 177 patients in the treatment group and 68 in the control group. Patients were more likely to follow up to outpatient palliative care services if referred for pain management. Hospital system, prior inpatient palliative care, and number of outpatient visits were associated with an increased likelihood for ED visits and hospital readmissions. Those in the palliative care treatment group were also more likely to have ACP discussions.
Conclusion Early implementation of outpatient palliative care among patients with HNC can initiate ACP discussions. However, there are discrepancies in referral reasons to palliative care and continued existing barriers to its effective utilization. |
| first_indexed | 2024-04-12T09:15:41Z |
| format | Article |
| id | doaj.art-16546355842448f0bd43b7a0809d7f83 |
| institution | Directory Open Access Journal |
| issn | 1809-9777 1809-4864 |
| language | English |
| last_indexed | 2024-04-12T09:15:41Z |
| publishDate | 2022-10-01 |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | International Archives of Otorhinolaryngology |
| spelling | doaj.art-16546355842448f0bd43b7a0809d7f832022-12-22T03:38:51ZengThieme Revinter Publicações Ltda.International Archives of Otorhinolaryngology1809-97771809-48642022-10-012604e538e54710.1055/s-0041-1741436Referral Patterns of Outpatient Palliative Care among the Head and Neck Cancer PopulationAri Saravia0Keonho Albert Kong1Ryan Roy2Rachel Barry3Christine Guidry4Lee S. McDaniel5Mary C. Raven6Anna M. Pou7Ashley C. Mays8Louisiana State University School of Medicine, New Orleans, Louisiana, United StatesDepartment of Otolaryngology, University of North Carolina-Chapel Hill , Chapel Hill, North Carolina USALouisiana State University School of Medicine, New Orleans, Louisiana, United StatesBarry Ear Nose and Throat. 4212 W Congress St, Suite 1500, Lafayette, Louisiana, USADepartment of Palliative Medicine, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, United StatesDepartment of Biostatistics, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United StatesDepartment of Palliative Medicine, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, United StatesOschner Health System, New Orleans, Louisiana, USADepartment of Otolaryngology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United StatesIntroduction Patients with head and neck cancer (HNC) experience unique physical and psychosocial challenges that impact their health and quality of life. Early implementation of palliative care has been shown to improve various health care outcomes. Objective The aim of the present study was to evaluate the patterns of referral of patients with HNC to outpatient palliative care as they relate to utilization of resources and end-of-life discussions. Methods We performed a retrospective review of 245 patients with HNC referred to outpatient palliative care services at two Louisiana tertiary care centers from June 1, 2014, to October 1, 2019. The control group consisted of those that were referred but did not follow-up. Reasons for referral were obtained, and outcome measures such as emergency department (ED) visits, hospital readmissions, and advance care planning (ACP) documentation were assessed according to predictive variables. Results There were 177 patients in the treatment group and 68 in the control group. Patients were more likely to follow up to outpatient palliative care services if referred for pain management. Hospital system, prior inpatient palliative care, and number of outpatient visits were associated with an increased likelihood for ED visits and hospital readmissions. Those in the palliative care treatment group were also more likely to have ACP discussions. Conclusion Early implementation of outpatient palliative care among patients with HNC can initiate ACP discussions. However, there are discrepancies in referral reasons to palliative care and continued existing barriers to its effective utilization.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1741436palliative carehead and neck cancerpain managementsymptom managementresource utilizationadvance care planning |
| spellingShingle | Ari Saravia Keonho Albert Kong Ryan Roy Rachel Barry Christine Guidry Lee S. McDaniel Mary C. Raven Anna M. Pou Ashley C. Mays Referral Patterns of Outpatient Palliative Care among the Head and Neck Cancer Population International Archives of Otorhinolaryngology palliative care head and neck cancer pain management symptom management resource utilization advance care planning |
| title | Referral Patterns of Outpatient Palliative Care among the Head and Neck Cancer Population |
| title_full | Referral Patterns of Outpatient Palliative Care among the Head and Neck Cancer Population |
| title_fullStr | Referral Patterns of Outpatient Palliative Care among the Head and Neck Cancer Population |
| title_full_unstemmed | Referral Patterns of Outpatient Palliative Care among the Head and Neck Cancer Population |
| title_short | Referral Patterns of Outpatient Palliative Care among the Head and Neck Cancer Population |
| title_sort | referral patterns of outpatient palliative care among the head and neck cancer population |
| topic | palliative care head and neck cancer pain management symptom management resource utilization advance care planning |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1741436 |
| work_keys_str_mv | AT arisaravia referralpatternsofoutpatientpalliativecareamongtheheadandneckcancerpopulation AT keonhoalbertkong referralpatternsofoutpatientpalliativecareamongtheheadandneckcancerpopulation AT ryanroy referralpatternsofoutpatientpalliativecareamongtheheadandneckcancerpopulation AT rachelbarry referralpatternsofoutpatientpalliativecareamongtheheadandneckcancerpopulation AT christineguidry referralpatternsofoutpatientpalliativecareamongtheheadandneckcancerpopulation AT leesmcdaniel referralpatternsofoutpatientpalliativecareamongtheheadandneckcancerpopulation AT marycraven referralpatternsofoutpatientpalliativecareamongtheheadandneckcancerpopulation AT annampou referralpatternsofoutpatientpalliativecareamongtheheadandneckcancerpopulation AT ashleycmays referralpatternsofoutpatientpalliativecareamongtheheadandneckcancerpopulation |