Researchers report that integration of supportive and palliative oncology care (SPOC) into routine practice may improve patient and family experiences. These study findings were published in the Journal of Advanced Practitioner Oncology.

In 2017, the American Society for Clinical Oncology (ASCO) recommended palliative care in addition to usual care for patients with advanced or metastatic cancers. This SPOC quality improvement (QI) project was launched at a single center in Washington state to develop and implement such care into routine practice.

The SPOC team comprised 4 oncologists, 1 advanced practice practitioner (APP), and nursing, ancillary staff, and specialized pharmacists.

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Between September 2020 and May 2021, 49 patients participated in the SPOC program; participants’ mean age was 72 years and 95.9% were White. They were referred to the SPOC program by oncologists (83.7%) for pain management (36.7%) and goals of care (30.6%).

During the 10-month QI project, the SPOC program had 239 patient encounters, of which 116 were face-to-face visits. Overall, patients had an average of 4.9 visits each.

The most frequent patient concerns were pain (89.8%), fatigue (73.5%), appetite loss (59.2%), and weakness (55.1%). SPOC visits often assisted with advanced care planning, in which 93.9% completed goals of care, 42.9% completed an advanced directive, and 25.0% updated a previously completed advanced directive.

A total of 136 referrals were made, including 16 to specialty palliative care, 16 to therapy services (physical, speech, and occupational), and 10 to integrative medicine.

Overall, 81.3% of patients were admitted to hospice and 32.7% died. Most deaths (93.8%) occurred at home. The average length of stay in hospice was 27.8 days.

“Integration of SPOC principles into routine oncology practice is an opportunity to improve the patient and family experience while demonstrating the value of APPs at the clinical and organizational level,” concluded the study authors.


Motschenbacher C, Cohn T. Integration of an APP-led supportive and palliative oncology care program: a quality improvement project. J Adv Pract Oncol. 2023;14(2):118-125. doi:10.6004/jadpro.2023.14.2.2