Both palliative care (PC) and supportive care (SP) are integral to patient care. However, some studies have reported that palliative care is often misperceived as "the end of the line" for patients and their care team, as a time when patients discontinue active treatment and enter hospice.
PC primarily aims to provide relief from pain and other distressing symptoms. It can be offered to all patients with serious health-related suffering due to severe illness, regardless of their stage, and can greatly improve quality of life.
SC is typically thought of as involving treatment management and post-treatment issues. It alleviates symptoms and complications of severe illnesses, reduces or prevents treatment toxicities, supports communication with patients about their disease and prognosis, and eases patients and their caregivers' emotional burdens.
A newly identified supportive care — one that incorporates the traditional notions about palliative care — dispels the idea of sequential timing, and should proactively be offered to patients.
A study carried out in 2009 indicated that referrals to the PC unit at MD Anderson Cancer Center in Houston, USA, typically happened late in the course of a patient's illness. Assuming that negative perceptions about PC posed an obstacle to early patient referral, researchers conducted a survey among mid-level providers and medical oncologists. This study disclosed that they preferred “supportive care” over “palliative care” and stated a greater likelihood to refer patients on active primary and advanced cancer treatments to a service named "Supportive Care."
As a follow-up to this study, the team changed the name of the unit, which led to dramatic results. In a study of records of 4,701 consecutive patients with a first PC consultation before and after the name change, they found a 41% increase in PC consultations, mainly as a result of a rise in inpatient referrals. In the outpatient setting, they found a shorter duration from hospital registration to PC consultation, and from advanced cancer diagnosis to PC consultation. The results also included a longer overall survival duration from PC consultation.
Beyond the name change, an additional step to facilitate earlier PC referrals is to motivate oncologists to see patients along with their primary care team earlier rather than later.
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Adapted from Medscape News & Perspective. Rebranding palliative care as supportive care may boost use. Available at https://www.medscape.com/viewarticle/921488. Internet. Accessed on January 23, 2020. To view the entire article and all other content on the Medscape News and Perspective site, a free, one-time registration is required.