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Early palliative care, defined as beginning 6-24 months prior to end of life, is widely recommended due to demonstrated improvements in quality of life, symptom management, satisfaction with care, and mood for patients. Despite these benefits, late referrals continue to be the norm and many primary and specialized palliative care physicians indicate they lack the resources to provide early palliative care.
To better understand the issue, Sue-A-Quan and colleagues (2023) conducted a survey of primary and specialized Canadian palliative care physicians to describe their perspectives regarding the conditions necessary to provide early palliative care.
The survey included a Likert scale to assess attitudes and optional regarding the provision of early palliative care and an optional free-text section. This article describes the analysis of the free-text comments related to conditions necessary to provide early palliative care.
The research team identified a list of 2,116 physicians who indicated their practice included palliative care. From this list 823 physicians agreed to participate in future surveys and 531 responded to the full survey. Responses from 104 physicians were included in a thematic analysis of the free-text comments.
Four themes emerged including:
- Clear delineation of roles of primary and specialized palliative care physicians, recognizing the importance of primary care physicians’ longitudinal relationship with patients.
- Shared care with needs-dependent referral based on physical and psychological needs, not prognosis.
- Adequate resources to support primary palliative care, including palliative care education for primary care physicians, financial incentives to provide palliative care and linking community nurses with primary care.
- Addressing the misconception that palliative care equals end-of-life care, and the assumption that referral to palliative care means the patient is imminently dying. There is an opportunity to educate both the public as well as referring physicians.
The authors suggest that the four themes may be used as a framework to guide further research or to identify strategy to improve early palliative care.
Source: Sue-A-Quan, R., Sorensen, A., Lo, S., Pope, A., Swami, N., Rodin, G., … & Zimmermann, C. (2023). Palliative Care Physicians’ Perceptions of Conditions Required to Provide Early Palliative Care. Journal of Pain and Symptom Management.
