Evidence map›Paper›PMID 33652096›Full record

ArticleJournal of pain and symptom management2021

Pre-Post Evaluation of Collaborative Oncology Palliative Care for Patients With Stage IV Cancer.

Laura C Hanson, Kathryn L Wessell, Jenny Hanspal, Feng-Chang Lin, Frances A Collichio, Darren DeWalt, Matthew I Milowsky, Donald L Rosenstein, Gary S Winzelberg, William A Wood and 1 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of pain and symptom management, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 45% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Laura C HansonDivision of Geriatric Medicine, University of North Carolina at Chapel Hill (L.C.H., G.S.W.), Chapel Hill, North Carolina, USA; Palliative Care Program, University of North Carolina at Chapel Hill (L.C.H., J.H., G.S.W.), Chapel Hill, North Carolina, USA; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill (L.C.H., K.L.W.), Chapel Hill, North Carolina, USA. Electronic address: laura_hanson@med.unc.edu.
Kathryn L WessellCecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill (L.C.H., K.L.W.), Chapel Hill, North Carolina, USA.
Jenny HanspalPalliative Care Program, University of North Carolina at Chapel Hill (L.C.H., J.H., G.S.W.), Chapel Hill, North Carolina, USA.
Feng-Chang LinDepartment of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (F.-C.L.), Chapel Hill, North Carolina, USA.
Frances A CollichioDivision of Hematology and Oncology, University of North Carolina at Chapel Hill (F.A.C., M.I.M., W.A.W.), Chapel Hill, North Carolina, USA.
Darren DeWaltDivision of General Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill (D.D.), Chapel Hill, North Carolina, USA.
Matthew I MilowskyDivision of Hematology and Oncology, University of North Carolina at Chapel Hill (F.A.C., M.I.M., W.A.W.), Chapel Hill, North Carolina, USA.
Donald L RosensteinDepartment of Psychiatry, University of North Carolina at Chapel Hill (D.L.R.), Chapel Hill, North Carolina, USA.
Gary S WinzelbergDivision of Geriatric Medicine, University of North Carolina at Chapel Hill (L.C.H., G.S.W.), Chapel Hill, North Carolina, USA; Palliative Care Program, University of North Carolina at Chapel Hill (L.C.H., J.H., G.S.W.), Chapel Hill, North Carolina, USA.
William A WoodDivision of Hematology and Oncology, University of North Carolina at Chapel Hill (F.A.C., M.I.M., W.A.W.), Chapel Hill, North Carolina, USA.
Natalie C ErnecoffDivision of General Internal Medicine, University of Pittsburgh School of Medicine (N.C.E.), Pittsburgh, Pennsylvania, USA.
University of North Carolina at Chapel Hill · US

Funding

Virology Research Program (Program 4)P30CA016086 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Deborah F. Tate · 1985 to 2026
$201.5M
NCI NIH HHS P30 CA016086
6 · The paper itself

Abstract

contextThe Collaborative Care Model improves care processes and outcomes but has never been tested for palliative care.

objectivesTo develop and evaluate a model of collaborative oncology palliative care for Stage IV cancer.

methodsWe conducted a pre-post evaluation of Collaborative Oncology Palliative Care (CO-Pal), enrolling patients with Stage IV lung, breast or genitourinary cancers and acute illness hospitalization. CO-Pal has 4 components: 1) oncologist communication skills training; 2) patient tracking; 3) palliative care needs assessment; and 4) care coordination stratified by high vs. low palliative care need. Health record reviews from hospital admission through 60 days provided data on outcomes - goals-of-care discussions (primary outcome), advance care planning, symptom treatment, specialty palliative care and hospice use, and hospital transfers.

resultsWe enrolled 256 patients (n = 114 pre and n = 142 post-intervention); 60-day mortality was 32%. Comparing patients pre vs post-intervention, CO-Pal did not increase overall goals-of-care discussions, but did increase advance care planning (48% vs 63%, P = 0.021) and hospice use (19% vs 31%, P = 0.034). CO-Pal did not impact symptom treatment, overall treatment plans, or 60-day hospital transfers. During the intervention phase, high-need vs low-need patients had more goals-of-care discussions (60% vs. 15%, P < 0.001) and more use of specialty palliative care (64% vs 22%, P < 0.001) and hospice (44% vs 16%, P < 0.001).

conclusionCollaborative oncology palliative care is efficient and feasible. While it did not increase overall goals-of-care discussions, it was effective to increase overall advance care planning and hospice use for patients with Stage IV cancer.

Indexed as

Advance Care PlanningHospice and Palliative Care NursingHospice CareNeoplasmsHumansPalliative Carecancercollaborative carePalliative care

Identifiers

PMID33652096
PMCPMC8390587
OpenAlexW3134535806

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.