On August 16, the Journal of Oncology Practice (JOP) published a joint guidance statement from ASCO and the American Academy of Hospice and Palliative Medicine (AAHPM) regarding high-quality palliative care as delivered directly by medical oncology practices themselves.
ASCO has long recommended integrating palliative care into the usual care of patients with advanced cancer or high symptom burden to promote better patient and caregiver outcomes. However, specialist palliative care teams are not widely available to all cancer patients.
As opposed to care delivered by palliative care specialists, this statement provides further guidance regarding specific aspects of palliative care that should be part of routine cancer care, as provided by the medical oncology practice itself, described as primary palliative care in oncology.
The statement acknowledges the clear overlap between patient care delivered by oncology specialists and by palliative care specialists, and describes an expert consensus definition of what parts and processes of patient care (within a palliative care frame) should be considered by a medical oncology practice wishing to deliver high-quality primary palliative care. Panelists assessed 966 palliative care service items in nine domains and evaluated them in the constructs of importance, feasibility, and scope of medical oncology practice. (The authors did not participate in the panel.)
The statement provides a broad overview of the service items included in the consensus definition. For example, in the domain of “Symptom Assessment and Management,” symptoms should be assessed and managed at a basic level, with more comprehensive management for common symptoms such as nausea, vomiting, diarrhea, dyspnea, and pain. In the domain of “Appropriate Palliative Care and Hospice Referral,” practices should be able to accurately describe the difference between palliative care and hospice to their patients and refer them to these services appropriately. Details regarding the exact palliative care service items are included in the appendix.
Palliative care assessment and management spans a large number of services for both patients and their families. Palliative care supports a patient’s physical, emotional, spiritual, and social needs from diagnosis through treatment and beyond. Oncology providers and practices seeking to enhance their own primary palliative care delivery will find this information useful to inform operational changes and quality improvement efforts.
Read the full statement.