Timely integration of palliative care into oncology care for patients with bone metastases at the radiotherapy department: A pilot study on acceptability and feasibility

Abstract

Background and aim

Patients with bone metastases may have needs that extend beyond the management of pain by radiotherapy. Concurrent palliative care leads to improved quality of life, but is often introduced late. In this pilot study, we assessed the acceptability and feasibility of an introdu0000ctory conversation with a palliative care consultant at referral for palliative radiotherapy.

Material and methods

Patients with bone metastases and their family caregivers were scheduled for an introductory conversation with a consultant from the hospital palliative care team. During this meeting, the potential benefits of integrating palliative care into their current or future care was discussed. Using statements on a 5-point Likert scale, patients and family caregivers independently evaluated the acceptability of the conversation, and consultants evaluated the feasibility.

Results

Between December 2022 and March 2024, 48 patients were included in the study. Median age was 73 years, 63 % were male. Most patients (89 %) and family caregivers (96 %) appreciated the introductory conversation, were unaware of the existence of a palliative care team (60 %, 67 %, respectively), and would contact the team when having questions or concerns (77 %, 82 %). Some found the conversation confronting (17 %, 11 %), or felt it was too early in the illness trajectory (31 %, 26 %). Follow-up consultations were scheduled for 8 patients (17 %). Consultants were able to conduct the conversation as instructed (91 %), though 15 % indicated insufficient time for preparation.

Conclusion

Introductory conversations about palliative care at referral for palliative radiotherapy appear both acceptable and feasible, and may enhance timely integration of palliative care into oncology care for patients with bone metastases.