Addressing symptoms and coping were found to be the most prevalent components of early ambulatory palliative care clinic visits in recent research focusing on the emerging practice of early ambulatory palliative care.
Jaclyn Yoong, MBBS, of the Massachusetts General Hospital in Boston, and fellow researchers randomly selected 20 persons with newly diagnosed metastatic non-small cell lung cancer who had received early palliative care and survived within four periods (five patients per period):
- less than 3 months
- 3 to 6 months
- 6 to 12 months
- 12 to 24 months.
The researchers then analyzed palliative care and oncologic visit notes from the electronic health records of these patients.
As Yoong’s group described in JAMA Internal Medicine, symptoms and coping were the main components of the palliative care clinic visits. Initial visits focused on building relationships and rapport with patients and their families and on illness understanding, including prognostic awareness. Discussions of resuscitation preferences and hospice mainly occurred during later visits.
When the investigators compared palliative care and oncologic visits around critical time points, they found that both included discussions about symptoms and illness status. However, the palliative care visits emphasized coping and other psychosocial elements, whereas the oncologic care visits focused on disease treatment and management of medical complications.
The distinct features of the two types of visits during critical clinical time points suggest a key role for palliative care involvement and enable oncologists to focus on cancer treatment and managing medical complications, concluded the authors.