Photo Credit: Pornpak Khunatorn

The following is a summary of “Specialist Palliative Care Referral Practices Among Oncologists, Cardiologists, Respirologists: A Comparison of National Survey Studies,” published in the JULY 2023 issue of Pain Management by Bonares, et al.

Patients with nonmalignant diseases have similar palliative care needs to cancer patients but are less likely to receive specialist palliative care (SPC). To understand the reasons for this difference, examining referral practices of oncologists, cardiologists, and respirologists can provide valuable insights. For a study, researchers sought to compare the referral practices to SPC among cardiologists, respirologists, and oncologists, using data from surveys conducted in Canada.

The study involved a descriptive comparison of survey studies and a multivariable linear regression analysis to assess the association between medical specialty and referral frequency. Surveys were distributed to physicians across Canada in 2010 (oncologists) and 2018 (cardiologists, respirologists).

The combined response rate of the surveys was 60.9%, with a total of 1,568 respondents: 603 oncologists, 534 cardiologists, and 431 respirologists. The perceived availability of SPC services was higher for cancer patients compared to noncancer patients. Oncologists were more likely to make a referral to SPC for symptomatic patients with a prognosis of less than one year. Cardiologists and respirologists, on the other hand, were more likely to make a referral at a prognosis of less than one month and would refer earlier if palliative care was renamed supportive care. Adjusting for demographic and professional characteristics, both cardiologists and respirologists had a lower frequency of referrals compared to oncologists (P < 0.0001 for both groups).

In 2018, cardiologists and respirologists had poorer perceived availability of SPC services, delayed timing of referral, and lower frequency of referrals compared to oncologists in 2010. Further research was necessary to understand the reasons behind these differences in referral practices and to develop interventions to address them.

Source: jpsmjournal.com/article/S0885-3924(23)00041-6/fulltext