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. 2024 Apr;67(4):337-345.e2.
doi: 10.1016/j.jpainsymman.2024.01.013. Epub 2024 Jan 14.

Piloting a Patient Tool to Aid Palliative Care Referrals during Advanced Lung Cancer Treatment

Laurie E McLouth  1 , Jerod L Stapleton  2 , Vilma Bursac  3 , Carina M Zelaya  4 , Brent J Shelton  5 , Kshitij Thakur  6 , Isaac Hands  7 , Chaney Blu  7 , Ming-Yuan Chih  8 , Jessica M McFarlin  9
Affiliations

Piloting a Patient Tool to Aid Palliative Care Referrals during Advanced Lung Cancer Treatment

Laurie E McLouth et al. J Pain Symptom Manage. 2024 Apr.

Abstract

Context: Patient misperceptions are a strong barrier to early palliative care discussions and referrals during advanced lung cancer treatment.

Objectives: We developed and tested the acceptability of a web-based patient-facing palliative care education and screening tool intended for use in a planned multilevel intervention (i.e., patient, clinician, system-level targets).

Methods: We elicited feedback from advanced lung cancer patients (n = 6), oncology and palliative care clinicians (n = 4), and a clinic administrator (n = 1) on the perceived relevance of the intervention. We then tested the prototype of a patient-facing tool for patient acceptability and preliminary effects on patient palliative care knowledge and motivation.

Results: Partners agreed that the intervention-clinician palliative care education and an electronic health record-integrated patient tool-is relevant and their feedback informed development of the patient prototype. Advanced stage lung cancer patients (n = 20; age 60 ± 9.8; 40% male; 70% with a technical degree or less) reviewed and rated the prototype on a five-point scale for acceptability (4.48 ± 0.55), appropriateness (4.37 ± 0.62), and feasibility (4.43 ± 0.59). After using the prototype, 75% were interested in using palliative care and 80% were more motivated to talk to their oncologist about it. Of patients who had or were at risk of having misperceptions about palliative care (e.g., conflating it with hospice), 100% no longer held the misperceptions after using the prototype.

Conclusion: The palliative care education and screening tool is acceptable to patients and may address misperceptions and motivate palliative care discussions during treatment.

Keywords: Palliative care; advanced stage lung cancer; clinician education; improved referral process; palliative care misperceptions; patient-requested referral.

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Conflict of interest statement

Conflicts of Interest: None to declare.

Figures

Figure 1.
Figure 1.. Theoretical model and planned multilevel intervention targets for mPal.
*COM-B (Capability/knowledge, Opportunity, Motivation–Behavior) Model and Behavior Change Wheel Constructs (19, 22); EHR: electronic health record.
Figure 2.
Figure 2.. Multilevel intervention workflow after Phase I.
See this image and copyright information in PMC

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