Author of

• 11946

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  P2.24 - Poster Session 2 - Supportive Care (ID 157)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11975

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    P2.24-029 - Patterns of palliative care involvement in metastatic non-small cell lung cancer patients: Limitations of early palliative care in a rural Australian centre (ID 2062)

    09:30 - 09:30  |  Author(s): S. Kondalsamy-Chennakesavan
    • Abstract

    Background
    A number of studies have demonstrated that early palliative care involvement in the care of metastatic non-small cell lung cancer patients leads to significant improvements in quality of life, symptom control, and survival. Most studies, however, were performed in large centres where palliative care service is readily available. The North West Cancer Centre is a comprehensive rural Australian cancer centre. In this study, we reviewed our patterns of palliative care involvement, seeking to examine the current practices in the light of our limitations.

    Methods
    Retrospective analysis of patients with metastatic adenocarcinoma of the lung in the North West Cancer Centre between January 2008 to December 2012.

    Results
    We identified 35 patients with stage IV adenocarcinoma of the lung. The median duration to first review by palliative care is 126 days (range 28 - 669 days). Median duration from first review by palliative care to time of death is 22 days (range 11 - 152 days). Both are calculated from time of first review in medical oncology clinic. Further analysis revealed only 10 patients reviewed by a palliative care physician, with a median duration to first review of 227 days (range from 76 to 670 days). 25 patients were reviewed by specialist palliative care nurses, with a median duration to first review of 382 days (range from 76 to 676.5 days). 30 patients required inpatient palliative care, however only 7 were admitted under a specialist palliative care unit. 8 patients are currently alive. 5 patients received no palliative care input.

    Conclusion
    Lung cancer patients in rural and remote communities are known to have poorer prognosis compared to their urban counterparts. Our study further highlights this disparity. Early palliative care is becoming a standard of care. However, there are unique challenges facing a rural cancer centre that limits feasibility of early palliative care involvement in rural and remote lung cancer patients. A limited number of specialist palliative care health care providers service a large area (map). Currently we have 1 part-time specialist palliative care physician and 2 specialist palliative care nurses, catering for inpatient, ambulatory, and community palliative care patients. Our study found significant involvement of non-palliative care specialist health care providers assisting in provision of palliative care services. It is our impression that increasing awareness and education of the supporting health care providers is imperative to improving delivery of palliative care in a rural setting.