Primary Palliative Care for Cancer: Podcast with Yael Schenker and Bob Arnold
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\\u201cThe take home message of this study is NOT that primary palliative care does not work.\\u201d\\xa0 So says Yael Schenker of the negative study of an oncology nurse-led primary palliative care intervention for people with advanced cancer.
And we pushed Yael and Bob Arnold (senior author) on this point - we have several negative studies of primary palliative care (see links below to podcasts)\\xa0 - is it time to start to question the effectiveness of primary palliative care?\\xa0
We certainly all agree on the problem: we have only enough palliative care specialists to care for some small proportion of the population of people with serious illness.\\xa0 But when we move away from specialist palliative care to primary palliative care do we lose something critical? Perhaps we cannot train primary providers (front line nurses and doctors generally) to deliver palliative care that is \\u201cgood enough\\u201d to impact outcomes.
That\\u2019s one interpretation.\\xa0 Another is that we need a \\u201cstronger dose\\u201d of primary palliative care.\\xa0 In Yael and Bob\\u2019s study nurses averaged 2.2 visits, hardly robust longitudinal palliative care.\\xa0 Patients who had 3 visits had better outcomes.
Unpacking negative studies is just as interesting as unpacking positive studies.\\xa0 Knowing what doesn\\u2019t work is just as important as knowing what does.
Links:
- Negative multi-national study of primary palliative care in nursing homes
- Negative ICU primary palliative care intervention
- Project ENABLE
- Podcast on palliative care\\u2019s diversity problem
- Systematic review of palliative care
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