Survey on use of palliative radiotherapy in hospice care.
OBJECTIVE
Radiation oncologists and hospice professionals both provide end-of-life care for oncology patients, and little has been written about the interface between these two groups of specialists. Hospice professionals were surveyed to assess the perceived need for palliative radiotherapy in the hospice setting, to investigate factors that limit the access of hospice patients to radiotherapy, and to suggest areas of future collaboration on education, research, and patient advocacy.


METHODS
Members of the National Hospice and Palliative Care Organization (NHPCO) and American Society for Therapeutic Radiology and Oncology jointly authored a questionnaire to investigate the beliefs of hospice professionals toward the use of radiotherapy for oncology patients in hospice. The questionnaire was distributed to all NHPCO member institutions, and the results were compiled and statistically analyzed.


RESULTS
Four hundred eighty of more than 1,800 surveyed facilities responded to the questionnaire. The findings suggest that the majority of hospice professionals feel that radiotherapy is important in palliative oncology and that radiotherapy is widely available in the United States. Yet less than 3% on average of hospice patients served by hospices responding to the survey actually received radiotherapy in 2002. The most common barriers to radiotherapy in hospice care include radiotherapy expense, transportation difficulties, short life expectancy, and educational deficiencies between the specialties.


CONCLUSIONS
Multiple barriers act to limit the use of palliative radiotherapy in hospice care. Finding ways to surmount these obstacles will provide opportunity for improvement in the end-of-life care of cancer patients.
Lutz
Stephen
S
Department of Radiation Oncology, Blanchard Valley Regional Cancer Center, Findlay, OH 45840, USA. slutz@bvha.org
Spence
Carol
C
Chow
Edward
E
Janjan
Nora
N
Connor
Stephen
S
D001291:Attitude of Health Personnel; D001859:Bone Neoplasms / Q000532:radiotherapy / Q000556:secondary; D019538:Health Care Surveys; D006297:Health Services Accessibility; D017051:Hospice Care; D006801:Humans; D009369:Neoplasms / Q000532:radiotherapy*; D010166:Palliative Care / Q000706:statistics & numerical data*; D011788:Quality of Life; D018787:Radiation Oncology; D011878:Radiotherapy / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013727:Terminal Care