ASCO and the American Academy of Hospice and Palliative Care Medicine (AAHPM) have announced a joint initiative to support delivery of high-quality palliative care in medical oncology. The initiative, funded by the Agency for Health Care Research & Quality, aims to address the complex care needs of patients with advanced cancer, including relief or prevention of symptoms.
The 3-year project will create a virtual learning collaborative (VLC)—a Web-based technology platform—to efficiently and broadly disseminate evidence-based palliative care approaches in oncology. The VLC will include coordinated, customized learning modules, social networking capabilities, and a toolbox of evidence-based resources to help translate the latest research into practice.
“We recognize that palliative care is an essential component of care for patients with cancer. This partnership will help get the latest palliative care evidence directly into the hands of oncologists so that palliative care can be provided as early as possible,” said ASCO President Sandra M. Swain, MD, FACP. “Never before has a national study tested a technology platform, like the VLC, to spread practice-changing palliative care research and connect oncologists to share best practices and promote improvement.”
The partnership between ASCO and AAHPM to forward broad implementation of palliative care for patients who need it is also practice-changing. Current AAHPM President, Timothy E. Quill, MD, FACP, FAAHPM, and President-Elect Amy P. Abernethy, MD, FACP, FAAHPM, coauthored a recent piece in TheNew England Journal of Medicine on the importance of coordinated generalist-plus-specialist palliative care.1
“The oncologist or treating specialist could manage many palliative care problems, initiating a specialist palliative care consultation for more complex situations. The VLC moves this goal from concept to practical reality,” said Dr. Abernethy, an oncologist and palliative medicine physician, and Principal Investigator on the VLC grant.
Twenty oncology practices from around the country will be recruited to participate in a structured practice improvement pilot project, enabled by the VLC. Pilot practices will report data on palliative care quality using ASCO’s Quality Oncology Practice Initiative (QOPI®). They will share best practices and resources through the VLC, and benefit from expert and peer guidance as they implement local improvements.
Qualitative and quantitative evaluation will assess oncology practitioners’ perceptions of the VLC, assess the impact of the VLC on performance related to primary palliative care, and inform additional refinements to the platform and the toolbox of content and resources. Ultimately, project leaders aim to provide a proven palliative care toolbox to all ASCO members for use in their practices, and to leverage the VLC platform to address other targets for practice improvement.
Despite a growing consensus about the benefits of routine palliative care in oncology, results from QOPI demonstrate the need for improved symptom management, greater attention to psychosocial issues, discussions about goals of care, and appropriate referral to hospice—all core skills of palliative care.
“The VLC project builds on ASCO’s long-standing leadership in fostering the delivery of palliative care in the oncology setting,” said Dr. Abernethy. “As palliative care is increasingly woven into the fabric of health care across specialties, it will be critical to see that it is well integrated within the cancer care delivery system.”
Palliative care emphasizes medically appropriate goal setting, open communication with patients and families, and meticulous symptom assessment and control. Palliative care interventions have been shown to improve patients’ life quality, symptoms, and satisfaction, as well as reduce caregiver stress. Research has confirmed the benefits of palliative care for patients with advanced cancer. Studies have shown that patients who received early palliative care had a better quality of life, less depression, and in some cases lived longer than those who had routine care. ■
1. Quill TE, Abernethy AP: Generalist plusspecialist palliative care—creating a more sustainable model. N Engl J Med. March 6, 2013 (early release online).