Timing of palliative care referral does not impact healthcare utilization in patients with pancreatic cancer
The timing of palliative care referrals (PCR) in individuals diagnosed with pancreatic ductal adenocarcinoma (PDAC) does not play a substantial role in healthcare utilization, particularly hospital admissions, according to a study.
Of the 1458 patients with PDAC included in the study, 419 individuals (28.7%) were referred for palliative care. Overall, 67.3% of those who received PCR (n = 282) had been referred for palliative care at a later stage, defined as 30 days or more after their definitive PDAC diagnosis. The demographic analysis of the patients found that the majority were of White ethnicity (85%) and male (54.8%), with a median age of 62 years at the time of PDAC diagnosis.
Patients who received an early PCR were more frequently diagnosed with advanced stage 4 disease (69%) compared to those who received a late PCR. Patients who underwent a late PCR were more commonly diagnosed with stage 1, 2, or 3 cancer (53.2%). This disparity in disease stage distribution was statistically significant (P < 0.001).
The study also delved into healthcare utilization patterns among these patients. Patients who were referred for early PCR had fewer median emergency department visits (1 vs 2, P < 0.001) and hospital admissions (1 vs 2, P < 0.001) compared to those who received late PCR. However, when employing recurrent-event Cox-proportional hazards models, the research team found that the timing of PCR did not have a significant impact on hospital admissions (HR 0.88, 95% CI 0.68, 1.14; p = 0.3).
Gonzalez R, Srinivas S, Waterman BL, et al. Impact of early vs late palliative care referrals on healthcare utilization in patients with pancreatic cancer. J Cancer Res Clin Oncol. 2023;doi: 10.1007/s00432-023-05113-2. Epub ahead of print. PMID: 37610676.