PurposeTo identify elements of timely integration of palliative care (PC) into hospital oncology care from best practices. Thereafter, to assess the level of consensus among oncology and PC specialists and patient and relative representatives on the characteristics of timely integration of PC.MethodsA three-round modified Delphi study was conducted. The expert panel consisted of 83 healthcare professionals (HCPs) from 21 Dutch hospitals (43 physicians, 40 nurses), 6 patient and 2 relative representatives. In the first round, four elements of integrated PC were considered: (1) identification of potential PC needs, (2) advance care planning (ACP), (3) routine symptom monitoring and (4) involvement of the specialist palliative care team (SPCT). In subsequent rounds, the panellists assessed which characteristics were triggers for initiating an element. A priori consensus was set at >= 70%.ResultsA total of 71 (78%) panellists completed the first questionnaire, 65 (71%) the second and 49 (54%) the third. Panellists agreed that all patients with incurable cancer should have their PC needs assessed (97%), symptoms monitored (91%) and ACP initiated (86%). The SPCT should be involved at the patient's request (86%) or when patients suffer from increased symptom burden on multiple dimensions (76%). Patients with a life expectancy of less than 3 months should be offered a consultation (71%).ConclusionThe expert panel agreed that timely integration of PC into oncology is important for all patients with incurable cancer, using early identification, ACP and routine symptom monitoring. Involvement of the SPCT is particularly needed in patients with multidimensional symptom burden and in those nearing death.
机构:
Mem Sloan Kettering Canc Ctr, Dept Med Med Oncol, 1275 York Ave, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Med Med Oncol, 1275 York Ave, New York, NY 10065 USA
Agarwal, Rajiv
;
Epstein, Andrew S.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, Gastrointestinal Oncol Serv, 1275 York Ave, New York, NY 10021 USA
Mem Sloan Kettering Canc Ctr, Palliat Med Serv, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, Dept Med Med Oncol, 1275 York Ave, New York, NY 10065 USA
机构:
Univ Alabama Birmingham, Birmingham, AL 35294 USA
Dartmouth Hitchcock Med Ctr, Lebanon, NH 03766 USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Bakitas, Marie A.
;
Tosteson, Tor D.
论文数: 0引用数: 0
h-index: 0
机构:
Geisel Sch Med Dartmouth, Hanover, NH USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Tosteson, Tor D.
;
Li, Zhigang
论文数: 0引用数: 0
h-index: 0
机构:
Dartmouth Coll, Hanover, NH 03755 USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Li, Zhigang
;
Lyons, Kathleen D.
论文数: 0引用数: 0
h-index: 0
机构:
Geisel Sch Med Dartmouth, Hanover, NH USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Lyons, Kathleen D.
;
Hull, Jay G.
论文数: 0引用数: 0
h-index: 0
机构:
Dartmouth Coll, Hanover, NH 03755 USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Hull, Jay G.
;
Li, Zhongze
论文数: 0引用数: 0
h-index: 0
机构:
Norris Cotton Canc Ctr, Lebanon, NH USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Li, Zhongze
;
Dionne-Odom, J. Nicholas
论文数: 0引用数: 0
h-index: 0
机构:
Univ Alabama Birmingham, Birmingham, AL 35294 USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Dionne-Odom, J. Nicholas
;
Frost, Jennifer
论文数: 0引用数: 0
h-index: 0
机构:
Dartmouth Hitchcock Med Ctr, Lebanon, NH 03766 USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Frost, Jennifer
;
Dragnev, Konstantin H.
论文数: 0引用数: 0
h-index: 0
机构:
Dartmouth Hitchcock Med Ctr, Lebanon, NH 03766 USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Dragnev, Konstantin H.
;
Hegel, Mark T.
论文数: 0引用数: 0
h-index: 0
机构:
Geisel Sch Med Dartmouth, Hanover, NH USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Hegel, Mark T.
;
论文数: 引用数:
h-index:
机构:
Azuero, Andres
;
Ahles, Tim A.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, New York, NY 10021 USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Univ N Carolina, Chapel Hill, NC USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Basch, Ethan
;
Deal, Allison M.
论文数: 0引用数: 0
h-index: 0
机构:
Univ N Carolina, Chapel Hill, NC USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Deal, Allison M.
;
Kris, Mark G.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Kris, Mark G.
;
Scher, Howard I.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Scher, Howard I.
;
Hudis, Clifford A.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Hudis, Clifford A.
;
Sabbatini, Paul
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Sabbatini, Paul
;
Rogak, Lauren
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Rogak, Lauren
;
Bennett, Antonia V.
论文数: 0引用数: 0
h-index: 0
机构:
Univ N Carolina, Chapel Hill, NC USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Bennett, Antonia V.
;
Dueck, Amylou C.
论文数: 0引用数: 0
h-index: 0
机构:
Mayo Clin, Scottsdale, AZ USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Dueck, Amylou C.
;
Atkinson, Thomas M.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Atkinson, Thomas M.
;
Chou, Joanne F.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Chou, Joanne F.
;
Dulko, Dorothy
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Dulko, Dorothy
;
Sit, Laura
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Sit, Laura
;
Barz, Allison
论文数: 0引用数: 0
h-index: 0
机构:
Childrens Hosp Philadelphia, Philadelphia, PA 19104 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Barz, Allison
;
Novotny, Paul
论文数: 0引用数: 0
h-index: 0
机构:
Mayo Clin, Rochester, MN USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Novotny, Paul
;
Fruscione, Michael
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Fruscione, Michael
;
Sloan, Jeff A.
论文数: 0引用数: 0
h-index: 0
机构:
Mayo Clin, Rochester, MN USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Sloan, Jeff A.
;
Schrag, Deborah
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Dana Farber Harvard Canc Ctr, Boston, MA USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
机构:
VUB, End Of Life Care Res Grp, Brussels, Belgium
Univ Ghent, Brussels, BelgiumVUB, End Of Life Care Res Grp, Brussels, Belgium
Pardon, K.
;
Van den Block, L.
论文数: 0引用数: 0
h-index: 0
机构:
VUB, End Of Life Care Res Grp, Brussels, Belgium
Univ Ghent, Brussels, BelgiumVUB, End Of Life Care Res Grp, Brussels, Belgium
Van den Block, L.
;
Devroey, D.
论文数: 0引用数: 0
h-index: 0
机构:
VUB, Dept Family Med & Chron Care, Brussels, BelgiumVUB, End Of Life Care Res Grp, Brussels, Belgium
Devroey, D.
;
Msc, M. De laat
论文数: 0引用数: 0
h-index: 0
机构:
Ghent Univ Hosp, Dept Med Oncol, Ghent, BelgiumVUB, End Of Life Care Res Grp, Brussels, Belgium
Msc, M. De laat
;
Geboes, K.
论文数: 0引用数: 0
h-index: 0
机构:
Ghent Univ Hosptial, Dept Internal Med, Ghent, BelgiumVUB, End Of Life Care Res Grp, Brussels, Belgium
Geboes, K.
;
Surmont, V.
论文数: 0引用数: 0
h-index: 0
机构:
Ghent Univ Hosp, Dept Resp Med, Ghent, BelgiumVUB, End Of Life Care Res Grp, Brussels, Belgium
Surmont, V.
;
Deliens, L.
论文数: 0引用数: 0
h-index: 0
机构:
VUB, End Of Life Care Res Grp, Brussels, Belgium
Univ Ghent, Brussels, Belgium
Ghent Univ Hosp, Dept Med Oncol, Ghent, BelgiumVUB, End Of Life Care Res Grp, Brussels, Belgium
机构:
Mem Sloan Kettering Canc Ctr, Dept Med Med Oncol, 1275 York Ave, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Med Med Oncol, 1275 York Ave, New York, NY 10065 USA
Agarwal, Rajiv
;
Epstein, Andrew S.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, Gastrointestinal Oncol Serv, 1275 York Ave, New York, NY 10021 USA
Mem Sloan Kettering Canc Ctr, Palliat Med Serv, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, Dept Med Med Oncol, 1275 York Ave, New York, NY 10065 USA
机构:
Univ Alabama Birmingham, Birmingham, AL 35294 USA
Dartmouth Hitchcock Med Ctr, Lebanon, NH 03766 USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Bakitas, Marie A.
;
Tosteson, Tor D.
论文数: 0引用数: 0
h-index: 0
机构:
Geisel Sch Med Dartmouth, Hanover, NH USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Tosteson, Tor D.
;
Li, Zhigang
论文数: 0引用数: 0
h-index: 0
机构:
Dartmouth Coll, Hanover, NH 03755 USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Li, Zhigang
;
Lyons, Kathleen D.
论文数: 0引用数: 0
h-index: 0
机构:
Geisel Sch Med Dartmouth, Hanover, NH USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Lyons, Kathleen D.
;
Hull, Jay G.
论文数: 0引用数: 0
h-index: 0
机构:
Dartmouth Coll, Hanover, NH 03755 USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Hull, Jay G.
;
Li, Zhongze
论文数: 0引用数: 0
h-index: 0
机构:
Norris Cotton Canc Ctr, Lebanon, NH USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Li, Zhongze
;
Dionne-Odom, J. Nicholas
论文数: 0引用数: 0
h-index: 0
机构:
Univ Alabama Birmingham, Birmingham, AL 35294 USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Dionne-Odom, J. Nicholas
;
Frost, Jennifer
论文数: 0引用数: 0
h-index: 0
机构:
Dartmouth Hitchcock Med Ctr, Lebanon, NH 03766 USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Frost, Jennifer
;
Dragnev, Konstantin H.
论文数: 0引用数: 0
h-index: 0
机构:
Dartmouth Hitchcock Med Ctr, Lebanon, NH 03766 USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Dragnev, Konstantin H.
;
Hegel, Mark T.
论文数: 0引用数: 0
h-index: 0
机构:
Geisel Sch Med Dartmouth, Hanover, NH USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
Hegel, Mark T.
;
论文数: 引用数:
h-index:
机构:
Azuero, Andres
;
Ahles, Tim A.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, New York, NY 10021 USAUniv Alabama Birmingham, Birmingham, AL 35294 USA
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Univ N Carolina, Chapel Hill, NC USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Basch, Ethan
;
Deal, Allison M.
论文数: 0引用数: 0
h-index: 0
机构:
Univ N Carolina, Chapel Hill, NC USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Deal, Allison M.
;
Kris, Mark G.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Kris, Mark G.
;
Scher, Howard I.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Scher, Howard I.
;
Hudis, Clifford A.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Hudis, Clifford A.
;
Sabbatini, Paul
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Sabbatini, Paul
;
Rogak, Lauren
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Rogak, Lauren
;
Bennett, Antonia V.
论文数: 0引用数: 0
h-index: 0
机构:
Univ N Carolina, Chapel Hill, NC USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Bennett, Antonia V.
;
Dueck, Amylou C.
论文数: 0引用数: 0
h-index: 0
机构:
Mayo Clin, Scottsdale, AZ USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Dueck, Amylou C.
;
Atkinson, Thomas M.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Atkinson, Thomas M.
;
Chou, Joanne F.
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Chou, Joanne F.
;
Dulko, Dorothy
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Dulko, Dorothy
;
Sit, Laura
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Sit, Laura
;
Barz, Allison
论文数: 0引用数: 0
h-index: 0
机构:
Childrens Hosp Philadelphia, Philadelphia, PA 19104 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Barz, Allison
;
Novotny, Paul
论文数: 0引用数: 0
h-index: 0
机构:
Mayo Clin, Rochester, MN USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Novotny, Paul
;
Fruscione, Michael
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Fruscione, Michael
;
Sloan, Jeff A.
论文数: 0引用数: 0
h-index: 0
机构:
Mayo Clin, Rochester, MN USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Sloan, Jeff A.
;
Schrag, Deborah
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
Dana Farber Harvard Canc Ctr, Boston, MA USAMem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA
机构:
VUB, End Of Life Care Res Grp, Brussels, Belgium
Univ Ghent, Brussels, BelgiumVUB, End Of Life Care Res Grp, Brussels, Belgium
Pardon, K.
;
Van den Block, L.
论文数: 0引用数: 0
h-index: 0
机构:
VUB, End Of Life Care Res Grp, Brussels, Belgium
Univ Ghent, Brussels, BelgiumVUB, End Of Life Care Res Grp, Brussels, Belgium
Van den Block, L.
;
Devroey, D.
论文数: 0引用数: 0
h-index: 0
机构:
VUB, Dept Family Med & Chron Care, Brussels, BelgiumVUB, End Of Life Care Res Grp, Brussels, Belgium
Devroey, D.
;
Msc, M. De laat
论文数: 0引用数: 0
h-index: 0
机构:
Ghent Univ Hosp, Dept Med Oncol, Ghent, BelgiumVUB, End Of Life Care Res Grp, Brussels, Belgium
Msc, M. De laat
;
Geboes, K.
论文数: 0引用数: 0
h-index: 0
机构:
Ghent Univ Hosptial, Dept Internal Med, Ghent, BelgiumVUB, End Of Life Care Res Grp, Brussels, Belgium
Geboes, K.
;
Surmont, V.
论文数: 0引用数: 0
h-index: 0
机构:
Ghent Univ Hosp, Dept Resp Med, Ghent, BelgiumVUB, End Of Life Care Res Grp, Brussels, Belgium
Surmont, V.
;
Deliens, L.
论文数: 0引用数: 0
h-index: 0
机构:
VUB, End Of Life Care Res Grp, Brussels, Belgium
Univ Ghent, Brussels, Belgium
Ghent Univ Hosp, Dept Med Oncol, Ghent, BelgiumVUB, End Of Life Care Res Grp, Brussels, Belgium