Palliative Care Use in Advanced Cancer in the Garden State.
Bridget L Nicholson, Linda Flynn, Beth Savage and 2 others
PMID 35398871WHAT IT FOUND
In New Jersey hospitalizations with metastatic cancer, only 15.4% had a palliative care consult.
Older age and documented pain were linked with more consults; depression alone was not.
Key findings
01Of 28697 hospitalizations of adults with metastatic cancer, 4429 (15.4%) had a palliative care consultation, and those with consultation were older on average (69.06 years) than those without (66.81 years).
02Documented pain was associated with consultation (26.9% of hospitalizations with pain had consultation), and absence of pain lowered odds (adjusted odds ratio 0.41); depression alone was not significant (P = .10, 16.4% of hospitalizations with depression had consultation).
03Two middle-income zip code categories had lower adjusted odds of consultation than the highest-income category (adjusted odds ratios 0.85 and 0.83).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis used hospitalizations, not unique patients, so one patient could appear more than once. Pain, depression, and palliative care consultation were identified by billing codes, which may miss symptoms or services. The database did not contain clinical details such as disease severity, response to therapy, prior palliative care, or reasons for not receiving consultation. It could not adjust for provider or hospital policies that may affect referral. The study was only in New Jersey, so the patterns may not apply elsewhere. Because it observed associations in records, it cannot show that any factor caused more or less palliative care consultation.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that depression does not matter for palliative care referral. The depression finding was not significant, and the authors note that depression may be underdetected when it is captured only by billing codes.