20 references to help you “make the case” for palliative care

Developed by Kathleen Kerr, Kerr Healthcare Analytics, with support from the Coalition for Compassionate Care of California
January 2016

Focus/Setting Key Point Reference Patient Population
1 Need for PC Bereaved families report substantial deficits in end-of-life care quality Teno JM, Freedman VA, Kasper JD, Gozalo P, Mor V. Is Care for the Dying Improving in the United States? J Palliat Med. 2015 Aug;18(8):662-6. Multiple disease groups
2 Need for PC For older Americans, care towards the end of life frequently includes emergency department visits, hospitalizations and in-hospital deaths Smith AK, McCarthy E, Weber E, Cenzer IS, Boscardin J, Fisher J, Covinsky K. Half Of Older Americans Seen In Emergency Department In Last Month Of Life; Most Admitted To Hospital, And Many Die There. Health Affairs, 31, no.6 (2012):1277-1285. Multiple disease groups
3 Need for PC For patients with chronic, progressive illnesses, care towards the end of life is often intensive and fragmented Teno JM, Gozalo PL, Bynum JP, Leland NE, Miller SC, Morden NE, Scupp T, Goodman DC, Mor V. Change in End-of-Life Care for Medicare Beneficiaries Site of Death, Place of Care, and Health Care Transitions in 2000, 2005, and 2009. JAMA. 2013 Feb 6;309(5):470-7. Multiple disease groups
4 Need for PC The need for palliative care is especially acute in the Medicaid population Mack JW, Chen K, Boscoe FP, Gesten FC, Roohan PJ, Weeks JC, Schymura MJ, Schrag D. Underuse of Hospice Care by Medicaid-insured Patients with Stage IV Lung Cancer in New York and California. J Clin Oncol. 2013 Jul 10;31(20):2569-79. Cancer
5 Need for PC While inpatient PC is important, outpatient PC is the more effective mechanism for impacting frequency of hospitalization, site of death and hospice utilization Blackhall LJ, Read P, Stukenborg G, Dillon P, Barclay J, Romano A, Harrison J. CARE Track for Advanced Cancer: Impact and Timing of an Outpatient Palliative Care Clinic. J Palliat Med. 2016 Jan;19(1):57-63. Cancer
6 PC Clinics Early, concurrent PC can improve multiple patient outcomes, including quality of life, mood, and survival Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF, Billings JA, Lynch TJ. Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer. N Engl J Med. 2010 Aug 19;363(8):733-42. Cancer
7 PC Clinics Early concurrent PC can improve the timing of chemotherapy delivery and the timing of transition to hospice care Greer JA, Pirl WF, Jackson VA, Muzikansky A, Lennes IT, Heist RS, Gallagher ER, Temel JS. Effect of early palliative care on chemotherapy use and end-of-life care in patients with metastatic non-small-cell lung cancer. J Clin Oncol 2012;30:394-400. Cancer
8 PC Clinics Clinic-based palliative care can improve patient symptoms Yennurajalingam S, Urbauer DL, Casper KL, Reyes-Gibby CC, Chacko R, Poulter V, Bruera E. Impact of a Palliative Care Consultation Team on Cancer-Related Symptoms in Advanced Cancer Patients Referred to an Outpatient Supportive Care Clinic. J Pain Symptom Manage. 2011 Jan;41(1):49-56. Cancer
9 PC Clinics Clinic-based PC can improve symptom control and patient satisfaction Follwell M, Burman D, Le LW, Wakimoto K, Seccareccia D, Bryson J, Rodin G, Zimmermann C. Phase II Study of an Outpatient Palliative Care Intervention in Patients With Metastatic Cancer. J Clin Oncol 2009;27:206–213. Cancer
10 PC Clinics Outpatient palliative care is associated with less aggressive end-of-life care Hui D, Kim SH, Roquemore J, Dev R, Chisholm G, Bruera E. Impact of Timing and Setting of Palliative Care Referral on Quality of End-of-Life Care in Cancer Patients. Cancer. 2014 Jun 1;120(11):1743-9. Cancer
11 PC Clinics Early PC is associated with less intensive medical care, improved quality outcomes, and lower costs at the end of life Scibetta C, Kerr K, Mcguire J, Rabow MW. The Costs of Waiting: Implications of the Timing of Palliative Care Consultation among a Cohort of Decedents at a Comprehensive Cancer Center. J Palliat Med. 2016 Jan;19(1):69-75. Cancer
12 Home-PC Home-PC can increase patient satisfaction while reducing use of medical services and costs of medical care at the end of life Brumley R, Enguidanos S, Jamison P, Seitz R, Morgenstern N, Saito S, McIlwane J, Hillary K, Gonzalez J. Increased Satisfaction with Care and Lower Costs: Results of a Randomized Trial of In-Home Palliative Care. J Am Geriatr Soc. 2007 Jul;55(7):993-1000. Multiple disease groups
13 Home-PC Home-PC can decrease use of inpatient services and increase documentation of goals of care and completion of advance directives Chen CY, Thorsteinsdottir B, Cha SS, Hanson GJ, Peterson SM, Rahman PA, Naessens JM, Takahashi PY. Health Care Outcomes and Advance Care Planning in Older Adults Who Receive Home-Based Palliative Care: A Pilot Cohort Study. J Palliat Med. 2015 Jan;18(1):38-44. Multiple disease groups
14 Home-PC Home-PC can improve symptom management, advance directive completion, patient satisfaction, and facilitate the transition to hospice care Kerr CW, Tangeman JC, Rudra CB, Grant PC, Luczkiewicz DL, Mylotte KM, Riemer WD, Marien MJ, Serehali AM. Clinical Impact of a Home-Based Palliative Care Program: A Hospice-Private Payer Partnership. J Pain Symptom Manage. 2014 Nov;48(5):883-92.e1 Multiple disease groups
15 Home-PC Payer-provider partnerships can support home-PC programs, thereby reducing costs while enhancing access to care across the continuum Kerr CW, Donohue KA, Tangeman JC, Serehali AM, Knodel SM, Grant PC, Luczkiewicz DL, Mylotte K, Marien MJ. Cost Savings and Enhanced Hospice Enrollment with a Home-Based Palliative Care Program Implemented as a Hospice–Private Payer Partnership. J Palliat Med. 2014 Dec;17(12):1328-35. Multiple disease groups
16 Home-PC Multiple models of Home-PC can reduce hospitalizations, emergency department visits and the likelihood of dying in the hospital Seow H, Brazil K, Sussman J, Pereira J, Marshall D, Austin PC, Husain A, Rangrej J, Barbera L. Impact of community based, specialist palliative care teams on hospitalisations and emergency department visits late in life and hospital deaths: a pooled analysis. BMJ. 2014 Jun 6;348:g3496. Multiple disease groups
17 Distance PC A nurse-led, palliative care-focused intervention addressing physical, psychosocial, and care coordination provided concurrently with oncology care can improve quality of life and mood among patients with advanced cancer Bakitas M, Lyons KD, Hegel MT, Balan S, Brokaw FC, Seville J, Hull JG, Li Z, Tosteson TD, Byock IR, Ahles TA. Effects of a Palliative Care Intervention on Clinical Outcomes in Patients With Advanced Cancer The Project ENABLE II Randomized Controlled Trial. JAMA. 2009 Aug 19;302(7):741-9. Cancer
18 Distance PC Early telephonic palliative care can reduce the incidence of depression and stress burden among family caregivers Dionne-Odom JN, Azuero A, Lyons KD, Hull JG, Tosteson T, Li Z, Frost J, Dragnev KH, Akyar I, Hegel MT, Bakitas MA. Benefits of Early Versus Delayed Palliative Care to Informal Family Caregivers of Patients With Advanced Cancer: Outcomes From the ENABLE III Randomized Controlled Trial. J Clin Oncol. 2015 May 1;33(13):1446-52. Cancer
19 Primary PC A nurse-led care management program can improve symptom management, advance care planning, emotional support and care coordination Schenker Y, White D, Rosenzweig M, Chu E, Moore C, Ellis P, Nikolajski P, Ford C, Tiver G, McCarthy L, Arnold R. Care Management by Oncology Nurses To Address Palliative Care Needs: A Pilot Trial To Assess Feasibility, Acceptability, and Perceived Effectiveness of the CONNECT Intervention. J Palliat Med. 2015 Mar;18(3):232-40. Cancer
20 Case Management Case management programs and liberalized hospice benefits can reduce barriers to hospice use and lower health care costs Spettell CM, Rawlins WS, Krakauer R, Fernandes J, Breton ME, Gowdy W, Brodeur S, MacCoy M, Brennan TA. A Comprehensive Case Management Program To Improve Palliative Care. J Palliat Med. 2009 Sep;12(9):827-32. Multiple disease groups