Hospice referral practices for children with cancer: a survey of pediatric oncologists

Title

Hospice referral practices for children with cancer: a survey of pediatric oncologists

Creator

Fowler K; Poehling K; Billheimer D; Hamilton R; Wu H; Mulder J; Frangoul H

Publisher

Journal Of Clinical Oncology

Date

2006

Subject

PedPal Lit; location of death; statistics & numerical data; Adult Female Health Care Surveys; Hospice Care Humans Male; Medical Oncology/statistics & numerical data Middle Aged Multivariate Analysis Neoplasms/complications/drug therapy/psychology/; Pediatrics/statistics & numerical data Physician's Practice Patterns/; Psychological/etiology/therapy Terminal Care United States; Referral and Consultation Stress; therapy Pain/etiology/therapy

Description

PURPOSE: To examine hospice referral patterns among pediatric oncologists and identify barriers to referral. METHODS: A self-administered survey was sent to 1,200 pediatric oncologists who are members of Children's Oncology Group. Two electronic mail messages followed by traditional mail surveys were sent to eligible physicians. Pediatricians and pediatric oncologists developed, pretested, and modified the survey for item clarification. RESULTS: Of 944 eligible pediatric oncologists surveyed, 632 replied, yielding a response rate of 67%. Most respondents reported having access to palliative care programs (65%) and hospice services (85%), but few (27%) had access to inpatient hospice services. More respondents reported feeling comfortable managing end-of-life pain than psychological issues (86% v 67%, respectively). Many pediatric oncologists (62%) reported that half or more of their patients died in the hospital. In multivariate analysis, physicians with access to hospice that accepts patients receiving chemotherapy had more patients die at home than in hospital compared with physicians without access to such services (P = .007). The probability of hospice referral was positively associated with the presence of a hospice facility (P < .001) and with a larger size oncology group (P = .024). Only 2.5% of respondents referred patients at the time of relapse. Continued therapy was cited as the most common reason for not making a referral, and was significantly higher when hospice did not admit children receiving chemotherapy (P = .002). CONCLUSION: Hospice referral for children with cancer is usually made late in the course of their disease and might improve if hospice admits patients who are actively receiving chemotherapy.
2006

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

1099-104

Issue

7

Volume

24

Citation

Fowler K; Poehling K; Billheimer D; Hamilton R; Wu H; Mulder J; Frangoul H, “Hospice referral practices for children with cancer: a survey of pediatric oncologists,” Pediatric Palliative Care Library, accessed July 6, 2022, https://pedpalascnetlibrary.omeka.net/items/show/13354.

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