Hospice, a well-established approach to palliative care, has enabled countless people worldwide to die with dignity. Through focusing on the patient rather than the disease, individuals can spend the last weeks of their lives in an environment where caregivers minimize their pain, maximize their comfort and provide bereavement services for loved ones and family members.
A study led by researchers at HMS has shown, however, that only about half of patients with metastatic lung cancer had discussed hospice care with their physician within four to seven months of diagnosis even though average survival after diagnosis is four to eight months. The findings were published in the May 25 Archives of Internal Medicine.
“Many terminally ill patients who might benefit from hospice aren’t discussing it with their physicians and may not be aware of the services hospice could offer,” said Haiden Huskamp, lead author on the study and HMS associate professor of healthcare policy.
Through the Cancer Care Outcomes Research and Surveillance Consortium, the team surveyed 1,517 patients with the disease. For reasons not clear, blacks and Hispanics were less likely to discuss hospice than whites and Asians. Forty-nine percent of blacks and 43 percent of Hispanics discussed hospice with their doctors; for whites and Asians the percentages were 53 percent and 57 percent, respectively. Married people were also less likely than unmarried people to have this discussion (51 percent compared with 57 percent, respectively).
“Patients with advanced lung cancer understandably hope that cancer treatments can extend their lives,” noted senior author John Ayanian, HMS professor of healthcare policy and of medicine at Brigham and Women’s Hospital. “When these treatments are no longer working, their doctors have an important role to play in offering them hospice care that will ease their symptoms as they approach the end of life.”
Students may contact Haiden Huskamp at huskamp@hcp.med.harvard.edu for more information.
Conflict Disclosure: The authors declare no conflicts of interest.
Funding Source: The National Cancer Institute
