Lack of Transfusion Services a Barrier to Hospice Care for Patients With Blood Cancers

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A lack of transfusion services figures among reasons oncologist may not recommend hospice for some patients.
A lack of transfusion services figures among reasons oncologist may not recommend hospice for some patients.

A lack of needed transfusion services was cited as the reason why many hematologic oncologists are less likely to refer their patients with blood cancers to home hospice care, according to survey results published in Cancer.1,2 

Patients with blood cancers have been shown to be less likely to enroll in hospice care compared with patients with solid tumors, and those who do enroll are likely to spend less time under hospice care. Furthermore, their decision is usually associated with a referral from their oncologist; therefore, Oreofe Odejide, MD, of the Dana-Farber Cancer Institute, and her colleagues sought to determine hematologist oncologists' perspectives regarding hospice.

For the study, the researchers surveyed a national sample of hematologic oncologists from the clinical directory of the American Society of Hematology. The survey sought their views regarding the helpfulness and adequacy of home hospice services for patients with blood cancers and what factors impact the likelihood of them referring their blood cancer patients to hospice.

A total of 349 physicians (response rate, 57.3%) responded to the survey. Survey responses indicated that most respondents (68.1%) strongly agreed that hospice care is “helpful” for patients with blood cancers. And, respondents whose practices had a greater number of patients with solid tumors were more likely to strongly agree (odds ratio, 2.10; 95% CI, 1.26-3.52).

However, almost half of the respondents (46%) described home hospice care as “inadequate” for these patients compared with the round-the-clock care of inpatient hospice. Their belief focused on the availability of red cell and/or platelet transfusions. Many of the respondents who believed hospice care is inadequate would consider referrals for these patients if red cell transfusions (67.3% vs 55.3% [P =.03]) or platelet transfusions (52.9% vs 39.7% [P =.02]) were available.

Although hematologic oncologists consider hospice care valuable, they are less likely to refer their patients with blood cancers to hospice care due to their concerns regarding the availability of services specific to patients with blood cancers. Hospice services need to be tailored to the specific needs of these patients to increase physician referrals and patient enrollment, the researchers conclude.

References

1. Why fewer blood cancer patients receive hospice care [news release]. Hoboken, NJ: Wiley; May 22, 2017. http://newsroom.wiley.com/press-release/cancer/why-fewer-blood-cancer-patients-receive-hospice-care. Accessed May 25, 2017.

2. Odejide OO, Cronin AM, Earle CC, Tulsky JA, Abel GA. Why are patients with blood cancers more likely to die without hospice? [published online May 22, 2017]. Cancer. doi: 10.1002/cncr.30735

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