Paul B. Jacobsen, PhD, FASCO, Associate Director of the National Cancer Institute’s Division of Cancer Control and Population Science’s Healthcare Delivery Research Program, said that this study exemplifies the type of work that is needed to more broadly and rapidly translate promising research findings in evidence-based recommendations for supportive care into routine clinical practice.

Paul B. Jacobsen, PhD, FASCO

“If a new regimen is presented at ASCO and produces benefits in terms of survival, it’s rapidly adopted because it typically fits into existing clinical delivery systems, but that’s not the case with interventions for supportive care,” said Dr. Jacobsen. “These complex interventions might involve the introduction of professionals, new clinical pathways, and changes to medical records. For this, we need to align implementation research…with the goal of improving patient outcomes.”

Moving Forward

According to Dr. Jacobsen, the fact that this intervention was developed and implemented with input from all stakeholders, especially providers and payers, has positive implications for sustainability. Moving forward, given the sensitive issues raises by end-of-life care, it will be important to incorporate the perspectives of bereaved surviving family members on this intervention as well as providers and payer, he proposed. Ultimately, however, building for the long term and possible institutionalization of this approach depends on the cost of implementation strategies.

“We saw some very positive results in a variety of aspects of health-care utilization at end of life that translated into approximately $7,000 reduction in costs,” said Dr. Jacobsen, who noted these findings are consistent with the growing body of research demonstrating a positive impact in palliative care. “Long-term sustainability, however, will depend on the continued presence of payer incentives.” 

DISCLOSURE: Dr. Jacobsen reported no conflicts of interest.