Researchers Identify Elements, Approaches, and Techniques of Early Palliative Care

Jason Hoffman, PharmD, RPh

October 27, 2014

During early palliative care, clinicians utilize six elements, four longitudinal approaches and three techniques.

During early palliative care, clinicians utilize six key elements, four longitudinal approaches and three specific techniques, a study reported at the 2014 Palliative Care in Oncology Symposium in Boston, Massachusetts (Abstract #2).

Researchers at Massachusetts General Hospital in Boston, Massachusetts, sought to investigate the content of early palliative care discussions in the ambulatory setting as part of an ongoing study of early palliative care in patients with advanced gastrointestinal and lung cancers.

To do so, researchers recorded audio of patients' outpatient palliative care clinic visits and selected three transcripts during the early, midway, and late clinical course from five patients. The researchers found that early palliative care typically consists of managing symptoms, promoting coping methods, and building the relationship with patients and their caregivers.
During clinical transitions, more frequent elements were guiding treatment decision making, boosting medical understanding, and advance care planning.

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In addition, the researchers identified four longitudinal methods that are applied during the patient-clinician relationship:

1. eliciting versus commenting on patients' perspectives
2. alluding to and preparing for the future
3. transitioning between managing symptoms and facilitating coping
4. transitioning between developing the relationship and facilitating coping

"These are methods of interacting with patients to address the elements of care over the disease course," Christopher Lim, BA, said while presenting at the symposium. Also, the team identified three techniques that palliative care clinicians use

1. coordinating with oncologists
2. providing referrals
3. addressing family dynamics

"In addition, the techniques underlie the broader approach to care in general to encompass both patients and their families," Lim said.