Patterns of palliative and psychosocial care in metastatic non-small cell lung cancer in South Western Sydney (#27)
Most patients with Non-Small Cell Lung Cancer (NSCLC) in South West Sydney (SWS) present with metastatic disease. Management goals for these patients are symptom palliation and quality of life maintenance. Referrals for palliative care (PC) and psychosocial care (PSC) are important factors in achieving these goals. The aim of this study was to evaluate PC and PSC utilisation in patients with metastatic NSCLC and identify factors associated with referral to these services.
A retrospective cohort of metastatic NSCLC patients, diagnosed between 2006-2012 who were SWS residents were identified from the SWS Local Health District Clinical Cancer Registry. Supplementary information was sourced from oncology and hospital electronic medical records and palliative care databases. Significant factors associated with PC and PSC referral and overall survival were determined using univariate and multivariate methods.
A total of 923 patients were identified. Median age was 69 years, 63% were male and 54% were born overseas. Active treatment was received by 65% of patients with 34% receiving chemotherapy and 65% receiving radiotherapy. 83% of patients had PC a referral, with 67% occurring within 8 weeks of diagnosis. 82% of patients were referred to PSC, with referrals to Social Workers being most frequent (76%). Multidisciplinary team discussion and receipt of active cancer treatment were both associated with referrals to PC and PSC (p= <0.001). Country of birth and language spoken were not associated with referral to either service. Median overall survival was 4.3 months and one year survival was 19% with no significant difference between those were and weren’t referred to PC.
Rates of referral to PC and PSC are high, but favour patients who receive active cancer treatment. Further investigation into referral gaps and quality indicators of PC will guide service delivery to improve quality of life and care for future patients.