A retrospective cohort study showed an improvement in receipt of timely specialty palliative care (SPC) over time for Medicare beneficiaries with metastatic non-small cell lung cancer (NSCLC). Results of the study were published in JCO Oncology Practice.1

In this study, the researchers examined patient data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database from the years 2001 through 2015. They analyzed baseline characteristics and outcomes for 79,253 patients with regard to the timing of receipt of specialty palliative care. Costs associated with the service were also evaluated.

In 2001, the median duration of time between diagnosis and first use of specialty palliative care was slightly more than 13 weeks, and in 2015 it was a little more than 8 weeks, reflecting a significant reduction in time (P <.001). The odds ratio for timely use of specialty palliative care when diagnosed in 2015 vs 2001 was 26.66 (95% CI, 19.53-36.37), based on multivariate analysis.

The outpatient setting showed a median time from diagnosis to first SPC service of 53 days, while in the hospice setting it was 91 days. Survival was also better in the outpatient setting (median, 124 days) compared with other settings (median, 107 days).


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The cost of specialty palliative care for patients with metastatic NSCLC rose during the study period. The average cost was $7993 in 2001, and it increased to $12,647 in 2015.

“In conclusion, timely SPC utilization has expanded for patients diagnosed with metastatic NSCLC over the past 15 years,” concluded the researchers in their report. This suggests that integration of palliative care with cancer care has improved, with outpatient SPC performing especially well in terms of both patient survival and cost, they noted.

Reference

Huo J, Hong YR, Turner K, et al. Timing, costs, and survival outcome of specialty palliative care in Medicare beneficiaries with metastatic non-small-cell lung cancer. JCO Oncol Pract. Published online October 2, 2020. doi:10.1200/OP.20.00298

This article originally appeared on Oncology Nurse Advisor