Clinical Characteristics of Cancer Patients Referred Early to Supportive and Palliative Care

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Abstract
Background: Palliative care is evolving from end-of-life care to care provided earlier in the disease trajectory. We compared clinical characteristics between patients referred late in the course of their disease (late referrals, LRs) with patients referred earlier (early referrals, ERs). Method: Six hundred and ninety-five patients referred to the Supportive Care Center (SCC) with follow-up within 30 days were enrolled. One hundred ERs (expected survival ≥2 years or receiving treatment for curative intent, 14.4%) were compared with a random sample of 100/595 consecutive LRs (all others). Results: ERs were younger (54.4 versus 59.5, p=0.009), more likely to have head and neck cancer (67% versys 6%, pp=0.014), and shorter disease duration until first palliative care consultation (3.8 months versus 16.2 months, pppp=0.0002). Head and neck cancer and reason for referral were independent predictors for ERs (pp=0.007). The median total number of medical visits was higher in ERs (ppConclusions: ERs had different patient characteristics than LRs, and although ERs experience distress similar to that of LRs, their needs and outcomes differ.

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