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|Issue 134||November 2017|
The report is a product of the VA/HSR&D Evidence Synthesis Program.
Evidence Report: Integrated Outpatient Palliative Care in Oncology
More than 500,000 Americans, including 40,000 Veterans, are diagnosed with advanced cancer annually in the United States. Often provided concurrently with oncology care, palliative care improves quality of life by managing patients' physical symptoms, as well as psychosocial and spiritual distress. Palliative care occurs across a continuum, ideally beginning at the time when a serious illness has been diagnosed and continuing until the end of life. Integration of palliative care and oncology care is now considered standard of care for patients with advanced cancer; however, the most effective approach to integrating care among multiple providers or across health systems has not been identified. Therefore, this evidence report was commissioned to answer the following key questions:
Investigators with VA's Evidence-based Synthesis Program site located in Durham, NC aimed to provide actionable information to VA healthcare providers, leaders, and policymakers regarding the potential benefits of palliative care integration among the diverse population of Veterans with cancer. Searching multiple data sources (MEDLINE, CINAHL, and the Cochrane Central Register of Controlled Trials) through November 21, 2016 to help answer questions #1 and #2, and through January 19, 2017 to answer question #3, investigators identified 1,988 articles for review. After applying exclusion and inclusion criteria, they used 24 articles -- including 13 primary papers and 11 companion papers (i.e., secondary publications and related papers) -- in their analyses.
Summary of Findings
Key Question #1
Key Question #2
Key Question #3
As it pertains to the VA, a key component of the Quality Enhancement Research Initiative (QUERI) program is to advance implementation science and identify effective strategies for implementing effective interventions. However, palliative care does not appear to be a particularly good fit into any of the 15 existing QUERI programs, so to pursue this, it is likely a new QUERI program would need to be formed that focuses on this issue.
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ESP is currently soliciting review topics from the broader VA community. Nominations will be accepted electronically using the online Topic Submission Form. If your topic is selected for a synthesis, you will be contacted by an ESP Center to refine the questions and determine a timeline for the report.
This Management e-Brief is provided to inform you about recent HSR&D findings that may be of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. If you have any questions or comments about this Brief, please email CIDER. The Center for Information Dissemination and Education Resources (CIDER) is a VA HSR&D Resource Center charged with disseminating important HSR&D findings and information to policy makers, managers, clinicians, and researchers working to improve the health and care of Veterans.
This report is a product of VA/HSR&D's Quality Enhancement Research Initiative's (QUERI) Evidence-Based Synthesis Program (ESP), which was established to provide timely and accurate synthesis of targeted healthcare topics of particular importance to VA managers and policymakers – and to disseminate these reports throughout VA.
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