Does it matter what you call it? A randomized trial of language used to describe palliative care services

Abstract

Introduction: Integration of palliative care into oncology practice remains suboptimal. Misperceptions about the meaning of palliative care may negatively impact utilization.

Purpose: We assessed whether the term and/or description of palliative care services affected patient views.

Methods: 2x2 between-subject randomized factorial telephone survey of 169 patients with advanced cancer. Patients were randomized into one of four groups that differed by name (supportive care vs. palliative care) and description (patient-centered vs. traditional). Main outcomes (0-10 Likert scale) were patient understanding, impressions, perceived need, and intended use of services.

Results: When compared to palliative care, the term supportive care was associated with better understanding (7.7 vs. 6.8; p = 0.021), more favorable impressions (8.4 vs. 7.3; p = 0.002), and higher future perceived need (8.6 vs. 7.7; p = 0.017). There was no difference in outcomes between traditional and patient-centered descriptions. In adjusted linear regression models, the term supportive care remained associated with more favorable impressions (p = 0.003) and higher future perceived need (p = 0.022) when compared to palliative care.

Conclusions: Patients with advanced cancer view the name supportive care more favorably than palliative care. Future efforts to integrate principles of palliative medicine into oncology may require changing impressions of palliative care or substituting the term supportive care.

Figure 1. Consort diagram detailing patient flow through the study including recruitment, randomization, and completion

†Patients were reached, requested call back, and were unable to reach on subsequent attempts *Patients were reached, requested call back after randomization, and were unable to reach on subsequent attempts **After randomization, patient was not reached during scheduled interview (n=1), patient died (n=1), was determined to be unable to complete without assistance (n=2), and interviewer deviated from standard script and decision was made not to be in final analysis (n=1)