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Oncology

Timing of palliative care referral does not impact healthcare utilization in patients with pancreatic cancer

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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).

Reference
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.

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