Patient Experience with Integrated Palliative Care Consult in Lung Transplant Evaluation Process

Abstract

Background: Several prominent societies have published statements promoting earlier integration of palliative care for patients with advanced lung disease. Our institution recently added palliative care consultation to the lung transplant evaluation process. Study Design: Patients (n=153) who underwent lung transplant evaluation were sent surveys. Of those, 29 had died, 10 asked to be excluded and 45 (36%) completed the survey. This included the 15-item Advance Care Planning (ACP) Engagement survey, a validated tool to assess readiness and self-efficacy. Results: The ACP-engagement survey showed high self-efficacy and readiness. Regarding potential bad outcomes after lung transplant, palliative care helped them feel more informed (63% “extremely”) and ready/prepared (59% “extremely”). A t-test compared mean scores between lung transplant provider team members. Pulmonologists were the most likely to help participants feel both informed and ready & prepared for potential bad outcomes (p=0.02). Overall, participants reported that the palliative care consult had a high impact. Conclusion: The palliative care visit specifically offered benefit in patient and medical decision maker preparation for potential bad outcomes, independent of their ACP engagement and knowledge about the visit beforehand.