Disparities Seen in Goals-of-Care Discussions With Minority vs Nonminority Patients

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Oncologists found to spend more time with nonminority patients discussing care goals than with minority patients.
Oncologists found to spend more time with nonminority patients discussing care goals than with minority patients.
The following article features coverage from the 2018 Palliative Care in Oncology Symposium meeting. Click here to read more of Oncology Nurse Advisor's conference coverage.

Oncologists tend to spend shorter lengths of time in conversations regarding goals of care (GOC) with minority vs nonminority patients, according to study results presented at the 2018 Palliative and Supportive Care in Oncology Symposium.

The quality of discussions regarding GOC and related topics can have direct consequences on a patient's treatment, survival, and quality of life, the researchers reported.

For this study, GOC discussions were those in which patients and physicians discussed the patients' treatment preferences and priorities related to their illness. The research team explored these interactions between 22 oncologists and their patients with newly diagnosed advanced-stage solid tumors and a survival prognosis of less than 2 years. Participants were recruited from academic, rural, municipal, and community hospitals in this randomized, controlled trial.

Audiotaped GOC discussions from 142 patient visits were quantified for this study based on median encounter time between each patient and the oncologist. Patients were Hispanic (19%), non-Hispanic Black (32%), and non-Hispanic White (38%).

The median length of GOC visit was 17 minutes for non-minority patients and 12 minutes for minority patients (P =.002). Median visit times were longer in cases of disease progression (18 minutes vs 13 minutes without progression; P =.007) and also ranged from 10 to 18 minutes (P =.009) among hospital sites.

With results accounting for both hospital site and disease progression, median visit times were still longer for nonminority patients (18 minutes) compared with those for minority patients (15 minutes; P =.02).

The study authors recommended exploring why GOC visits with oncologists were significantly shorter for minority patients than for nonminority patients to guarantee quality care.

Read more of Cancer Therapy Advisor's coverage of the 2018 Palliative Care in Oncology Symposium meeting by visiting the conference page.

Reference

Smith CB, Pintova S, Adelson KB, Gonsky JP, Egorova N, Bickell NA. Disparities in length of goals of care conversations between oncologists and patients with advanced cancer. J Clin Oncol. 2018;36(suppl34). Abstract 19.

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