Drivers of Palliative Care and Hospice Use Among Patients With Advanced Lung Cancer
ABSTRACT Purpose Despite rigorous evidence of improved quality of life and longer survival, disparities in the utilization of palliative and hospice care persist for racial and ethnic minority patients with cancer. This study evaluated the impact of psychosocial factors on utilization of these servi...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.70518 |
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| author | Megan C. Edmonds Melissa Mazor Mayuri Jain Lihua Li Marsha Augustin José Morillo Olivia S. Allen Amina Avril Juan P. Wisnivesky Cardinale B. Smith |
| author_facet | Megan C. Edmonds Melissa Mazor Mayuri Jain Lihua Li Marsha Augustin José Morillo Olivia S. Allen Amina Avril Juan P. Wisnivesky Cardinale B. Smith |
| author_sort | Megan C. Edmonds |
| collection | DOAJ |
| description | ABSTRACT Purpose Despite rigorous evidence of improved quality of life and longer survival, disparities in the utilization of palliative and hospice care persist for racial and ethnic minority patients with cancer. This study evaluated the impact of psychosocial factors on utilization of these services. Methods Patients with advanced lung cancer were recruited at a large academic urban hospital. Patients were surveyed about their knowledge of palliative care and hospice and their beliefs regarding medical mistrust, lung cancer care, palliative care and hospice. We used univariate and multivariable logistic regression analyses to examine the association between mistrust, knowledge and beliefs among the entire cohort and minority (Black and Hispanic) and non‐minority patients on utilization of palliative care consultation and hospice care use. Results Ninety‐nine of the enrolled participants had a mean age of 64 years. Minority patients were more likely to receive a palliative care referral (p < 0.001) and attend a consult (p = 0.003). Similarly, they were more likely to receive a hospice referral (p = 0.04), however there was no difference in hospice care use based on minority status (p = 0.102). In our adjusted model, older patients and those reporting negative lung cancer beliefs were more likely to receive hospice care (OR: 1.06, 95% CI: 1.004–1.138; OR: 1.04, 95% CI: 1.002–1.093, respectively). Conclusion Minority patients with advanced lung cancer were more likely to receive a palliative care referral and specialty level consultation when compared to non‐minority patients. Our work highlights the importance of proactive referral processes in facilitating access to palliative and hospice services, particularly among younger patients. |
| format | Article |
| id | doaj-art-9a8aaf524e25478bbed16f2fcf455f82 |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-9a8aaf524e25478bbed16f2fcf455f822025-01-24T08:46:07ZengWileyCancer Medicine2045-76342025-01-01142n/an/a10.1002/cam4.70518Drivers of Palliative Care and Hospice Use Among Patients With Advanced Lung CancerMegan C. Edmonds0Melissa Mazor1Mayuri Jain2Lihua Li3Marsha Augustin4José Morillo5Olivia S. Allen6Amina Avril7Juan P. Wisnivesky8Cardinale B. Smith9School of Public Health Virginia Commonwealth University Richmond Virginia USADivision of General Internal Medicine Icahn School of Medicine at Mount Sinai New York New York USADepartment of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York New York USADepartment of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York New York USADivision of General Internal Medicine Icahn School of Medicine at Mount Sinai New York New York USADivision of General Internal Medicine Icahn School of Medicine at Mount Sinai New York New York USAAlbert Einstein College of Medicine Bronx New York USADivision of General Internal Medicine Icahn School of Medicine at Mount Sinai New York New York USADivision of General Internal Medicine Icahn School of Medicine at Mount Sinai New York New York USAPopulation Health Science & Policy Icahn School of Medicine at Mount Sinai New York New York USAABSTRACT Purpose Despite rigorous evidence of improved quality of life and longer survival, disparities in the utilization of palliative and hospice care persist for racial and ethnic minority patients with cancer. This study evaluated the impact of psychosocial factors on utilization of these services. Methods Patients with advanced lung cancer were recruited at a large academic urban hospital. Patients were surveyed about their knowledge of palliative care and hospice and their beliefs regarding medical mistrust, lung cancer care, palliative care and hospice. We used univariate and multivariable logistic regression analyses to examine the association between mistrust, knowledge and beliefs among the entire cohort and minority (Black and Hispanic) and non‐minority patients on utilization of palliative care consultation and hospice care use. Results Ninety‐nine of the enrolled participants had a mean age of 64 years. Minority patients were more likely to receive a palliative care referral (p < 0.001) and attend a consult (p = 0.003). Similarly, they were more likely to receive a hospice referral (p = 0.04), however there was no difference in hospice care use based on minority status (p = 0.102). In our adjusted model, older patients and those reporting negative lung cancer beliefs were more likely to receive hospice care (OR: 1.06, 95% CI: 1.004–1.138; OR: 1.04, 95% CI: 1.002–1.093, respectively). Conclusion Minority patients with advanced lung cancer were more likely to receive a palliative care referral and specialty level consultation when compared to non‐minority patients. Our work highlights the importance of proactive referral processes in facilitating access to palliative and hospice services, particularly among younger patients.https://doi.org/10.1002/cam4.70518ethnic and racial minoritieshospice carelung cancer disparitiespalliative care |
| spellingShingle | Megan C. Edmonds Melissa Mazor Mayuri Jain Lihua Li Marsha Augustin José Morillo Olivia S. Allen Amina Avril Juan P. Wisnivesky Cardinale B. Smith Drivers of Palliative Care and Hospice Use Among Patients With Advanced Lung Cancer Cancer Medicine ethnic and racial minorities hospice care lung cancer disparities palliative care |
| title | Drivers of Palliative Care and Hospice Use Among Patients With Advanced Lung Cancer |
| title_full | Drivers of Palliative Care and Hospice Use Among Patients With Advanced Lung Cancer |
| title_fullStr | Drivers of Palliative Care and Hospice Use Among Patients With Advanced Lung Cancer |
| title_full_unstemmed | Drivers of Palliative Care and Hospice Use Among Patients With Advanced Lung Cancer |
| title_short | Drivers of Palliative Care and Hospice Use Among Patients With Advanced Lung Cancer |
| title_sort | drivers of palliative care and hospice use among patients with advanced lung cancer |
| topic | ethnic and racial minorities hospice care lung cancer disparities palliative care |
| url | https://doi.org/10.1002/cam4.70518 |
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