Lung cancer patients who receive palliative care interventions early in the course of their illness are more likely to survive than patients who do not, new research has found.
Veteran’s Affairs (VA) Portland Health Care System and Oregon Health and Science University researchers examined data from more than 23,000 patients with advanced lung cancer who received care through the VA, 57% of whom received palliative care. Patients who received palliative care between 31 and 365 days after their diagnosis lived longer than patients who did not receive any palliative care. The study appeared in the Sept. 19 issue of the Journal of the American Medical Association-Oncology.
The study also found that among lung cancer patients who do pass away, those who receive palliative care are less likely to die in a hospital or undergo aggressive treatment at the end-of-life than patients who do not receive palliative care.
Palliative care in an outpatient setting appeared to have the greatest impact, according to the study authors.
“Palliative care offered in outpatient settings rather than the intensive care unit is going to be an important component of this type of care. I think research like this gets more clinicians and patients thinking about the importance of palliative care,” said Donald Sullivan, with the VA Portland Health Care System Center to Improve Veteran Involvement in Care (CIVIC) and the Oregon Health and Science University Division of Pulmonary and Critical Care Medicine. “And I believe more Veterans with advanced cancer will receive this care along with other cancer therapies.”
Timing matters, however. Patients who began receiving palliative care a year or more after diagnosis were not more likely to survive.
A rising number of hospice providers are beginning to provide palliative care, though in the absence of a Medicare payment model many struggle to make their programs financially sustainable.
The benefits of palliative care for patients and families is well established, as are data on potential cost savings were palliative care offered more widely. Home-based palliative care could reduce societal health care costs by $103 billion within the next 20 years, the nonprofit economic research group Florida TaxWatch said in a report.
Palliative care in general can reduce health care costs by more than $4,000 per patient, according to a July 2017 study in Health Affairs. It can also reduce the frequency of 911 calls, emergency department visits, and unnecessary hospitalizations.Close to 60% of patients who would benefit from palliative care do not receive those services, despite the availability of community-based palliative care as well as hospital-based palliative care, according to a recent report from the New England Journal of Medicine Catalyst Insights Council.
Sullivan and his co-authors indicated that these findings, though specific to lung cancer, could apply to patients receiving care for other conditions as well.
“I have no reason to believe that these findings could not be generalized to patients with other serious conditions,” Sullivan said.