Apoyo con Carino: RCT of Patient Navigation to Improve Palliative Care Outcomes (FR417-C)

Abstract

Objectives 1. Recognize the need to assess and address symptoms and quality of life even among early stage lung cancer patients. 2. Identify the need for continued interdisciplinary palliative care for late stage lung cancer patients as they face the final stage of their cancer. 3. Describe the importance of educating the patient’s caregiver along the lung cancer trajectory. Background. Palliative cancer care addresses multiple issues that cause suffering for patients and caregivers, greatly impacting their quality of life. Research Objectives. This paper describes how symptoms, distress, and quality of life (QOL) data from the usual care phase of a NCI supported Program Project informed the development of an interdisciplinary, tailored palliative care intervention for patients with early (I-IIIB, n 1⁄4 103) and late (IV, n 1⁄4 114) stage lung cancer, and their caregivers (n 1⁄4 163). Method. Patient-reported outcomes were completed at baseline, 6, 12, and 24 weeks with Early Stage completing an additional 36 and 52 weeks. Caregivers completed outcome measures at baseline, 7, 12, 18, and 24 weeks. Result. Earlyd 55% female, 78% former smokers. IADLs, KPS, and Timed Up and Go fluctuated longitudinally, p 1⁄4.012, .044 and p 1⁄4.008 respectively. QOL decreased (FACT physical well-being subscale, p 32 hours/week. Caregivers were highly functional, experienced high levels of emotional stress, increased caregiver burden, decrease in perceived skills preparedness, and reported deterioration in psychological well being and overall QOL. Conclusion. Patients continue to experience high symptom burden, diminished physical well-being, and decreased QOL. Caregivers experience high levels of caregiver burden and report decreased psychological well being and overall QOL over time. Implications for Research, Policy, or Practice. There is a vital need for interdisciplinary palliative care interventions for patients with lung cancer and family caregivers. Phase II of this study is currently testing such an intervention based on Phase I results.