Blog | Friday, August 23, 2013

QD: News Every Day--Does the phrase 'palliative care' need a makeover?

Would rebranding palliative care improve patient cancer patients’ acceptance of it?

Patients and providers might both assume that palliative care—defined in a patient-centered model as relief from the symptoms, pain, and stress of a serious illness regardless of the diagnosis—means hospice care and that it can’t be combined with active treatment, wrote the authors.

To assess whether the term and/or description of palliative care services affected patient views, researchers conducted a telephone survey of 169 patients with advanced cancer. Patients were randomized into one of four groups that differed by name (supportive care vs. palliative care) and description (patient-centered vs. traditional) and were asked to rank on a 0-10 Likert scale their understanding, impressions, perceived need, and intended use of services.

Results appeared online at Supportive Care in Cancer.

When compared to palliative care, the term supportive care was associated with better understanding (7.7 vs. 6.8; P=0.021), more favorable impressions (8.4 vs. 7.3; P=0.002), and higher future perceived need (8.6 vs. 7.7; P=0.017). There was no difference in outcomes between traditional and patient-centered descriptions. When compared to the term “palliative care,” the term “supportive care” was associated with more favorable impressions (P=0.003) and higher future perceived need (P=0.022).

The authors wrote, “In our study, over half of the patients did not know what palliative care meant. This finding builds on prior research demonstrating a lack of familiarity with the term among oncology nurses and the general public, as well as among patients with cancer. Palliative care also lacks a standard definition in the supportive and palliative oncology literature.”

Further compounding the problem is that palliative care often occurs at the end of life, oncologists may define it as end-of-life care, and hospice care has been around longer. Researchers noted that the subspecialty board certification is called “Hospice and Palliative Medicine.”

Still, the authors concluded, oncologists could take advantage of patients’ lack of knowledge by introducing it in a more positive way, or by using a different term such as supportive care.