Palliative Care Consults Can Be Improved in Patients With Metastatic Breast Cancer

A study presented at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting found that just 38% of patients with breast cancer receive at least 1 palliative care consult following metastatic disease diagnosis.

Research has demonstrated that palliative care improves quality of end-of-life care and reduces costs for patients with cancer. Researchers conducted a retrospective assessment of deidentified electronic medical records from a national healthcare informatics provider and insurer between January 1, 2000, and December 31, 2018.

The study included US adult patients who were diagnosed with a secondary neoplasm after the index diagnosis of breast cancer and died during the study assessment period. Patients were categorized as those who received at least 1 palliative care consult on or after the date of metastasis through date of death (n=979) and those who did not receive a consult (n=1,636).

The researchers specially looked at the impact palliative care consult had on emergency department (ED), intensive care unit (ICU), and chemotherapy use.

Patient age at the last admission was 68.7 years, and median time from metastasis to death was 9 years (range, 2-24 years). Most women were white (79.8%), and nearly half were from the Midwest (47.1%). Age distribution was not significantly different between those who did and did not receive a consult, but those who did receive a palliative care consult were more likely to have shorter time to death (8 vs 10 years), be Black (12.8% vs 9.8%), reside in the Midwest (52.9% vs 43.7%), and have experienced complications since metastasis except for acute cerebrovascular events.

Patients who received a consult were more likely to use the ED (52.2% vs 22.2%) and ICU (12.5% vs 13.4%) within 2 months of death and to receive chemotherapy within 1 to 2 months of death (17.7% vs 13.9% and 12.9% vs 6.0%, respectively).

The findings “highlight the need to increase palliative care consults among metastatic breast cancer patients immediately following diagnosis to ensure appropriate care is provided and utilized,” the study authors concluded. “Furthermore, educational and informational interventions will need to be developed to boost palliative care consults utilization among metastatic breast cancer patients.”

Reference

Subramaniam DS, Zhang Z, Jenkins A, Hinyard LJ. Palliative care among metastatic breast cancer patients in the end-of-life period in the U.S. Abstract #e13002. Presented at the 2022 American Society of Clinical Oncology Annual Meeting; June 3-7, 2022; Chicago, IL.