Although palliative care has been shown to improve quality of life for patients with severe illnesses, two studies from St. Louis University researchers indicate it’s not offered frequently to patients who may benefit from the treatment.
Palliative care is treatment that helps manage side effects, symptoms and mental health issues for people with cancer and other severe illnesses.
One study, in the Journal of the American Heart Association, found that fewer than one in five patients newly diagnosed with heart failure received palliative care consultations. Another, in the journal Healthcare, found only one in four newly diagnosed pancreatic cancer patients had consultations.
“Even patients with the worst conditions, like pancreatic cancer, still just a small portion of them received proper and timely palliative care,” said Zidong Zhang, one of the authors of the two studies and a biostatician at SLU’s AHEAD Institute.
Palliative care can also include helping with insurance coverage and other practical support.
“Mental health is an issue, and also the psychosocial needs [of patients],” Zhang said. “What's the social life of these patients? Do they really have someone who cares? Do they have activities they really want to be still doing?”
Heart failure patients on Medicare who lived in the Northeast or Midwest were more likely to have palliative care than those with commercial insurance or those who lived in the South, the researchers found.
The study found Black people were 15% less likely to get such treatment compared with their white counterparts, the study found.
Black people’s historical distrust of the medical system may partially be to blame, the researchers said.
“We really also need to ask the question of what are we doing to address those barriers, why they're not getting access to that care,” said Divya Subramaniam, another author of the two studies. “We need to really understand: Is it a mistrust? Is it a lack of awareness?”
Patients of all races and backgrounds may think palliative care is the same as hospice treatment, she said. But although it can be part of hospice, using palliative care doesn’t mean a person isn’t going to get better, she said.
“I think when we say quality of life, we have to think about all aspects of quality of life,” Subramaniam said. “This includes not just physically, but ... psychologically as well.”
Barriers such as insurance access and the lack of primary care providers who offer palliative care could affect the number of people getting treatment.
Even when palliative care is offered, some patients’ needs may be going unaddressed, Subramaniam said.
She said the study of pancreatic cancer patients showed there was little likelihood palliative care would increase the likelihood of receiving mental health treatment.
That indicates a need to integrate more mental health care into palliative programs, she said.
