TY - JOUR
T1 - Perceptions of Hematology Among Palliative Care Physicians
T2 - Results of a Nationwide Survey
AU - Santivasi, Wil L.
AU - Childs, Daniel S.
AU - Wu, Kelly L.
AU - Partain, Daniel K.
AU - Litzow, Mark R.
AU - LeBlanc, Thomas W.
AU - Strand, Jacob J.
N1 - Funding Information:
This work was supported by funding from the Mayo Clinic Center for Palliative Medicine. mmc1.pdf
Funding Information:
None. W.L.S., D.S.C., K.L.W., D.K.P, M.R.L., and J.J.S. have no potential conflicts of interest to disclose. T.W.L.’s research is supported by grants and from the American Cancer Society, Duke University, the National Institutes of Health, Jazz Pharmaceuticals, and Seattle Genetics; receives royalties from UpToDate; serves in an advisory capacity to Agios, Astella, AstraZeneca, CareVive, Flat Iron, Helsinn, Otsuka, Pfizer, Seattle Genetics, Welvie, Abbvie, Amgen, Daiichi-Sankyo, Heron, and Medtronic; has received honoraria for lectures from Abbvie, Agios, BMS, and Celgene; and has received travel support from Abbvie, Agios, BMS, and Celgene.
Publisher Copyright:
© 2021 American Academy of Hospice and Palliative Medicine
PY - 2021/11
Y1 - 2021/11
N2 - Context: Palliative care integration for patients with hematologic diseases has lagged behind solid-organ malignancies. Previous work has characterized hematologist perspectives, but less is known about palliative care physician views of this phenomenon. Objectives: To examine palliative care physician attitudes and beliefs regarding hematologic diseases, patient care, and collaboration. Methods: A 44-item survey containing Likert and free-response items was mailed to 1000 AAHPM physician members. Sections explored respondent comfort with specific diagnoses, palliative care integration, relationships with hematologists, and hematology-specific patient care. Logistic regression models with generalized estimating equations were used to compare parallel Likert responses. Free responses were analyzed using thematic analysis. Results: The response rate was 55.5%. Respondents reported comfort managing symptoms in leukemia (84.0%), lymphoma (92.1%), multiple myeloma (92.9%), and following hematopoietic stem cell transplant (51.6%). Fewer expressed comfort with understanding disease trajectory (64.9%, 75.7%, 78.5%, and 35.4%) and discussing prognosis (71.0%, 82.6%, 81.6%, and 40.6%). 97.6% of respondents disagreed that palliative care and hematology are incompatible. 50.6% felt that palliative care physicians’ limited hematology-specific knowledge hinders collaboration. 89.4% felt that relapse should trigger referral. 80.0% felt that hospice referrals occurred late. In exploring perceptions of hematology-palliative care relationships, three themes were identified: misperceptions of palliative care, desire for integration, and lacking a shared model of understanding. Conclusion: These data inform efforts to integrate palliative care into hematologic care at large, echoing previous studies of hematologist perspectives. Palliative care physicians express enthusiasm for caring for these patients, desire for improved understanding of palliative care, and ongoing opportunities to improve hematology-specific knowledge and skills.
AB - Context: Palliative care integration for patients with hematologic diseases has lagged behind solid-organ malignancies. Previous work has characterized hematologist perspectives, but less is known about palliative care physician views of this phenomenon. Objectives: To examine palliative care physician attitudes and beliefs regarding hematologic diseases, patient care, and collaboration. Methods: A 44-item survey containing Likert and free-response items was mailed to 1000 AAHPM physician members. Sections explored respondent comfort with specific diagnoses, palliative care integration, relationships with hematologists, and hematology-specific patient care. Logistic regression models with generalized estimating equations were used to compare parallel Likert responses. Free responses were analyzed using thematic analysis. Results: The response rate was 55.5%. Respondents reported comfort managing symptoms in leukemia (84.0%), lymphoma (92.1%), multiple myeloma (92.9%), and following hematopoietic stem cell transplant (51.6%). Fewer expressed comfort with understanding disease trajectory (64.9%, 75.7%, 78.5%, and 35.4%) and discussing prognosis (71.0%, 82.6%, 81.6%, and 40.6%). 97.6% of respondents disagreed that palliative care and hematology are incompatible. 50.6% felt that palliative care physicians’ limited hematology-specific knowledge hinders collaboration. 89.4% felt that relapse should trigger referral. 80.0% felt that hospice referrals occurred late. In exploring perceptions of hematology-palliative care relationships, three themes were identified: misperceptions of palliative care, desire for integration, and lacking a shared model of understanding. Conclusion: These data inform efforts to integrate palliative care into hematologic care at large, echoing previous studies of hematologist perspectives. Palliative care physicians express enthusiasm for caring for these patients, desire for improved understanding of palliative care, and ongoing opportunities to improve hematology-specific knowledge and skills.
KW - Palliative care
KW - bone marrow transplantation
KW - hematologic diseases
KW - leukemia
KW - lymphoma
KW - multiple myeloma
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UR - http://www.scopus.com/inward/citedby.url?scp=85107922419&partnerID=8YFLogxK
U2 - 10.1016/j.jpainsymman.2021.04.021
DO - 10.1016/j.jpainsymman.2021.04.021
M3 - Article
C2 - 33933620
AN - SCOPUS:85107922419
SN - 0885-3924
VL - 62
SP - 949
EP - 959
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 5
ER -