- Palliative care was associated with better OS in patients with advanced lung cancer if initiated between 31 and 365 days after diagnosis.
Why this matters
- Despite studies suggesting a survival benefit, palliative care remains underused by patients, likely because of the perception that palliative care is for end-of-life care only.
- 23,154 patients diagnosed with stage IIIB-IV lung cancer between 2007 and 2013 who received care in the Veterans Affairs (VA) health care system.
- Funding: NIH; others.
- 57% of patients received palliative care.
- Palliative care use increased 41% during the study period.
- Overall, palliative care was associated with poorer OS (aHR, 1.19; 95% CI, 1.15-1.23), but was timing dependent:
- If initiated within 30 days of diagnosis, palliative care was associated with decreased OS (aHR, 2.13; 95% CI, 1.97-2.30).
- If initiated within 31-365 days after diagnosis, palliative care was associated with improved OS (aHR, 0.47; 95% CI, 0.45-0.49).
- No association with OS for palliative care initiated >365 days after diagnosis (aHR, 1.00; 95% CI, 0.94-1.07).
- Receipt of palliative care was associated with decreased mortality in an acute care setting (aOR, 0.57; 95% CI, 0.52-0.64).
- Retrospective study in an all-VA patient setting.
- Only 2% of participants were women.