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PaCES-Automatic study

Automatic Palliative Care Referrals: Acceptability and Uptake by Patients with Advanced Lung Cancer

Are phone invitations to a palliative care consultation acceptable to patients with advanced
lung cancer?
This is the research question we aim to answer through the CIHR-funded 'PaCES-Automatic' project.

Background:

People living with advanced (incurable) cancer are not routinely provided with timely access to a therapy that is proven to help them feel better, reduce depression and anxiety, and support their quality of life. That therapy is palliative care. Patients, and those close to them, experience high levels of distress when faced with a life-limiting diagnosis, and often don’t know that palliative care can be received at the same time as cancer treatments as an added layer of support. Other barriers to timely access to palliative care include cancer clinic time constraints, healthcare provider concerns that referring patients to palliative care might increase their distress, and cost of having a palliative care provider in every clinic. To overcome these barriers, our study asks “Can we develop a process so that everyone recently diagnosed with advanced cancer is automatically phoned by a palliative care provider and offered a consultation? Would patients find this phone call acceptable and how many would take up the offer of a comprehensive palliative care consultation?”

What will the study do?

We will work with patients and healthcare providers to design the process and appropriate language for these automatic referrals. We will then test the process, starting with people recently diagnosed with advanced (stage IV) lung cancer. 

We will interview patients about the acceptability of being called directly by a palliative care provider shortly after their advanced cancer diagnosis, and will measure how many patients attend a palliative care consultation.


Why do this? If acceptable, automatic referral will overcome existing barriers to palliative care referral and guarantee EVERY patient is offered early access to palliative care. If we find that direct phone contact is acceptable and leads to more people receiving timely palliative care, this will provide a routine, effective way to enhance the lives of all Canadians living with advanced cancers.

Resources developed through co-design process

The following resources were co-designed with patients and providers to facilitate automatic palliative care referrals for patients newly diagnosed with stage IV lung cancer:

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Process map

PaCES-Automatic process diagram depicts the processed involved in identifying eligible patients, calling patients to offer a supportive and palliative care consultation, and the research evaluation of the phone call 

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Supportive care handout

Supportive care handout provided to patients with newly diagnosed stage IV lung cancer at their first oncologist clinic visit

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Telephone script for automatic offer of palliative care

Telephone script used by Palliative Care Provider to offer a supportive and palliative care consultation

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Lung cancer resources

Resources for people newly diagnosed with lung cancer, developed in collaboration with Cancer Care Alberta

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Call Record

Call Record to be completed after each telephone call offering a supportive and palliative care consultation

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Post-Consult Visit Record

Post-Consult Visit Record to be completed after each supportive and palliative care consultation 

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Information for family physicians

Family physician letter with information on the PaCES-Automatic study

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