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Matthias Villalobos



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    ES05 - Joint Session GLCC/IASLC: Hot Topics for Lung Cancer Advocates (ID 8)

    • Event: WCLC 2019
    • Type: Educational Session
    • Track: Advocacy
    • Presentations: 1
    • Now Available
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      ES05.02 - From Living Longer to Also Living Better – the Role of Communication and Interprofessional Collaboration in Metastatic Lung Cancer (Now Available) (ID 3176)

      10:30 - 12:00  |  Presenting Author(s): Matthias Villalobos

      • Abstract
      • Presentation
      • Slides

      Abstract

      Despite ongoing progress in diagnostics and treatment, many patients with metastatic lung cancer still harbor a limited prognosis that may lead to existential uncertainty. These patients and their caregivers are confronted with a complex situation as burden comprises physical, psychosocial and spiritual needs [1]. During the illness trajectory they are exposed to different multiprofessional healthcare settings and providers that challenge the continuity and coordination of care. Therefore, the care of these patients and their relatives is often characterized by discontinuity, lack of coordination and insufficient communication [2]. Additionally, shared decision-making between active cancer treatment and end-of-life care constitutes a continuous and challenging balancing act for all who are involved in the process. Several studies have shown that early integration of palliative care (EPC) and adequate advance care planning (ACP) improve quality of life and satisfaction with care. Two studies evaluating EPC have even shown positive results in survival [3,4]. In the recommendation of the American Society of Clinical Oncology concerning the integration of palliative care into standard oncology care, the following were defined as essential components: “rapport and relationship building with patients and family caregivers; symptom, distress, and functional status management; exploration of understanding and education about illness and prognosis; clarification of treatment goals; assessment and support of coping needs; assistance with medical decision making; coordination with other care providers” [5]. This underlines the importance of communication in this setting and defines it as a central element for the effective provision of early palliative care. Another central element is interprofessional collaboration. Studies incorporating interprofessional involvement (notably physicians and nurses) showed more consistent results regarding the positive effects of EPC [6]. Through the different perspectives of the involved professions towards care needs, healthcare delivery may be enriched and become more holistic. Additionally, nurse navigation supports orientation in the healthcare system and provides continuity and coordination of care. For this strategy communication skills of healthcare providers and interprofessional collaboration should be strengthened. Joint communication training may play an important role to overcome interprofessional barriers and sharpen communication skills. Advanced communication techniques are essential for early integration of palliative care, facilitation of prognostic awareness, and by this means introduction or adaptation of advance care planning [7]. An interprofessional, longitudinally structured communication approach should improve the experience and outcomes of patients with advanced lung cancer and their caregivers [8]. Further research should address the feasibility of institutional strategies for implementing this approach.

      References:

      1 Baile WF, Palmer JL, Bruera E, Parker P: Assessment of palliative care cancer patients’ most important concerns. Support Care Cancer 2011;19:475-481.

      2 Gagliardi AR, Dobrow MJ, Wright FC: How can we improve cancer care? A review of interprofessional collaboration models and their use in clinical management. Surg Oncol 2011; 20:146–54.

      3 Bakitas MA, Tosteson TD, Li Z, Lyons KD, Hull JG, Li Z, Dionne-Odom JN, Frost J, Dragnev KH, Hegel MT, Azuero A, Ahles TA: Early Versus Delayed Initiation of Concurrent Palliative Oncology Care: Patient Outcomes in the ENABLE III Randomized Controlled Trial. J Clin Oncol 2015;33:1438-1445.

      4 Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF, Billings JA, Lynch TJ: Early Palliative Care for Patients with Metastatic Non-Small-Cell Lung Cancer. N Engl J Med 2010;363:733-42.

      5 Ferrell BR, Temel JS, Temin S, Alesi ER, Balboni TA, Basch EM, Firn JI, Paice JA, Peppercorn JM, Phillips T, Stovall EL, Zimmermann C, Smith T: Integration of palliative care into standard oncology care: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol 2017;35:96-112.

      6 Hui D, Bruera E: Integrating palliative care into the trajectory of cancer care. Nature Reviews Clinical Oncology 2016;13:159-71.

      7 Jackson VA, Jacobsen J, Greer JA, Pirl WF, Temel JS, Black AL: The cultivation of prognostic awareness through the provision of early palliative care in the ambulatory setting: a communication guide. Journal of Palliative Medicine 2013;16:894-900.

      8 Villalobos M, Siegle A, Hagelskamp L, Jung C, Thomas M. Communication along milestones in lung cancer patients with advanced disease. Oncology Research and Treatment 2019;42:41-46.

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