Most US Adults Unfamiliar With Palliative Care

(Reuters Health) – Nine in 10 U.S. adults may have inadequate knowledge about palliative care, particularly if they’re infrequent users of health care, a new study suggests.

Researchers examined data on responses from a total of 3,450 participants in the 2018 National Cancer Institute Health Information National Trends Survey (HINTS) 5 Cycle 2 to assess overall familiarity with palliative care as well as what factors might influence knowledge of this care modality.

Frequent health care utilization, defined as two or more visits annually, was associated with a significantly greater likelihood that participants would have knowledge of palliative care (OR 3.01), as was having a regular source of care (OR 2.67).

Advanced education also mattered. Compared to individuals without a high school diploma, those with a college or more advanced degree were significantly more likely to be familiar with palliative care (OR 13.83).

Women (OR 2.15) and married people (OR 2.02) were also significantly more likely to be knowledgeable about palliative care, researchers report in Cancer Epidemiology, Biomarkers, & Prevention.

“In addition to personal factors like gender, education level, marital factors, there are other extrinsic and important factors such as frequent engagement with health care professionals that can impact knowledge levels of palliative care,” said lead study author Motolani Ogunsanya, an assistant professor in the Department of Pharmacy, Clinical & Administrative Sciences at the University of Oklahoma Health Sciences Center in Oklahoma City.

Survey respondents were asked to describe their familiarity with palliative care in one of three ways: ‘I’ve never heard of it,’ ‘I know a little bit about palliative care,’ or ‘I know what palliative care is, and I could explain it to someone else.’ Researchers classified the first two responses as inadequate knowledge, and the final answer as adequate knowledge of palliative care.

One limitation of the study is that knowledge of palliative care was self-reported, not independently verified.

Even so, the results suggest that large portions of the population have little to no knowledge about what palliative care is, despite a growing body of evidence that this type of care can improve quality of life for patients and families, said Dr. Preeti Malani, director of the University of Michigan’s National Poll on Healthy Aging.

“The more that palliative care is normalized and framed as part of routine care, the better it will be received,” Dr. Malani, who wasn’t involved in the study, said by email.

Clinicians can help normalize the idea of palliative care by divorcing it from the misconception that it is exclusively for people who are at the very end of life, and stressing that it can be a normal and complementary aspect of standard high-quality healthcare for anyone with a serious illness at any stage of that disease, said Dio Kavalieratos, an associate professor of medicine and director of palliative care research at Emory University in Atlanta.

“Patients and families rely on their clinician to recognize a need for higher-level care and suggest a referral,” Kavalieratos, who wasn’t involved in the study, said by email.

SOURCE: Cancer, Epidemiology, Biomarkers & Prevention, online June 4, 2021.

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