Article

Majority of Advanced Cancer Patients Receive Palliative Care at ESMO Designated Centers

Survey findings show a high level of integration of palliative care in advanced cancer patients.

A recent survey revealed that 70% of advanced cancer patients receive palliative care consultation at European Society for Medical Oncology (ESMO) Designated Centres of Integrated Oncology and Palliative Care.

The goal of this worldwide initiative is to help ease the physical and mental suffering of cancer patients while they undergo cancer treatment, as well as at the end of their life. As of this year, 142 centers were awarded the Designated Centre distinction, increasing the total number of countries from 42 to 200.

Since 2003, the distinction has recognized cancer centers that achieve a high standard of integration of medical oncology and palliative care. The designation is valid for 3 years.

The goal of the study was to evaluate the characteristics and level of integration of palliative care services at ESMO Designated Centres, through a series of 78 questions. Responses were received from 152 of 184 centers (83%), of which 105 were in Europe. More than 80% responded that the program increased their status as cancer centers.

Programs reported that 70% of advanced cancer patients had palliative care consultation, which occurred in a median of 90 days before death for outpatients and 10 days for inpatients.

The survey also revealed that the Designated Centres had a high level of infrastructure to deliver palliative care to a large amount of advanced cancer patients. Additionally, 36% of centers were tertiary care cancer centers and 22% were tertiary care general hospitals. The median number of beds found was 550.

Ninety percent of the centers had inpatient consultation teams and 88% had outpatient palliative care clinics. Of these, 71% had dedicated acute care beds, while 50% offered community based palliative care.

Ninety-five percent of centers had interdisciplinary teams, and 65% had dually-certified palliative oncologists who were a palliative care specialist, in addition to a cancer specialist.

Over the past 3 years, all of the ESMO Designated Centres conducted palliative care research, with pain being the most common topic. In regards to education, 39% offered palliative care fellowship programs, 32% had mandatory palliative care rotations for medical oncology fellows, 52% had a didactic palliative care curriculum for oncology fellows, and 73% offered oncologists continuing medical education.

Authors note that the survey findings demonstrate a high level of integration amongst the growing community of ESMO Designated Centres of Integrated Oncology and Palliative Care.

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