Increases seen in both advance directives and end-of-life conversations for patients with advanced cancer
By Lori Solomon HealthDay Reporter
FRIDAY, April 7, 2023 (HealthDay News) — Nurse-led primary palliative care increases advance care planning (ACP) uptake among patients with advanced cancer, according to a study published in the April issue of the Journal of the National Comprehensive Cancer Network.
Michael G. Cohen, M.D., from the University of Pittsburgh School of Medicine, and colleagues assessed the impact of a nurse-led primary palliative care intervention on ACP uptake among patients with advanced cancer. Analysis included data from a trial in which patients with advanced cancer received either monthly primary palliative care visits with trained nurses within their cancer center or standard care.
The researchers found that 182 of 336 patients (54 percent) in the intervention arm and 196 of 336 (58 percent) in the standard care arm lacked an end-of-life conversation (EOLC) at baseline and completed the three-month assessment. Among these patients, at three months, 45.1 percent of patients in the intervention arm and 14.8 percent in the standard care arm reported having an EOLC (adjusted odds ratio, 5.28). At baseline, 33 percent of patients in the intervention arm and 31 percent in the standard care arm lacked an advance directive and completed the three-month assessment. Similarly, more patients in the intervention arm had an advance directive at three months (43.2 versus 18.1 percent; adjusted odds ratio, 3.68).
“Nurse-led primary palliative care increased ACP uptake among patients with advanced cancer,” the authors write. “Training oncology nurses embedded within community cancer centers to provide primary palliative care may help improve ACP access.”
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