title: Barriers to effective palliative care for low-income patients in late stages of cancer: report of a study and strategies for defining and conquering the barriers.
abstract: The discipline of palliative care is growing rapidly in the United States but, as in many other areas of medical care, multiple barriers exist to providing such care to low-income patients with end-stage cancer and other diseases. Reports vary with regard to definition and scope of these and other barriers. This article briefly reports a pilot study of perceived barriers to palliative care and related issues in an urban cancer clinic, reviews the current literature, and suggest ways to identify and overcome such barriers in low-income patients with cancer.
authors.affiliation: Division of Hematology/Oncology and Palliative Care, Massey Cancer Center, Virginia Commonwealth University School of Medicine, PO Box 980230, Richmond, VA 23298-0230, USA. lyckholm@vcu.edu
authors.forename: Laurie J
authors.initials: LJ
authors.lastname: Lyckholm
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Coyne
authors.forename: Kathleen O
authors.initials: KO
authors.lastname: Kreutzer
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Ramakrishnan
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Smith
mesh_terms: D000328:Adult; D016223:Advance Directives; D005260:Female; D019538:Health Care Surveys; D057220:Health Literacy; D006297:Health Services Accessibility / Q000191:economics*; D006738:Hospices / Q000706:statistics & numerical data; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D009369:Neoplasms / Q000628:therapy*; D010146:Pain / Q000188:drug therapy; D010166:Palliative Care / Q000191:economics* / Q000706:statistics & numerical data; D010865:Pilot Projects; D011203:Poverty; D018570:Risk Assessment; D014481:United States