title: Do patients with advanced cancer and unmet palliative care needs have an interest in receiving palliative care services?
abstract: BACKGROUND
  It is not known whether unmet palliative care needs are associated with an interest in palliative care services among patients with advanced cancer receiving ongoing oncology care.
  
  
  OBJECTIVE
  To assess the association between unmet palliative care needs and patient interest in subspecialty palliative care services.
  
  
  METHODS
  Cross-sectional telephone survey.
  
  
  METHODS
  One hundred sixty-nine patients with advanced cancer receiving care from 20 oncologists at two academic cancer centers.
  
  
  METHODS
  Surveys assessed palliative care needs in six domains. Patients were read a description of palliative care and then asked three questions about their current interest in subspecialty palliative care services (perceived need, likelihood of requesting, willingness to see if their oncologist recommended; all outcomes on 0-10 Likert scale).
  
  
  RESULTS
  The vast majority of patients described unmet palliative care needs, most commonly related to psychological/emotional distress (62%) and symptoms (62%). In fully adjusted models accounting for clustering by oncologist, unmet needs in these domains were associated with a higher perceived need for subspecialty palliative care services (psychological/emotional needs odds ratio [OR] 1.30; 95% confidence interval [CI] 1.06-1.58; p=0.01; symptom needs OR 1.27; 95% CI 1.01-1.60; p=0.04). There was no significant association between unmet needs and likelihood of requesting palliative care services. Willingness to see palliative care if oncologist recommended was high (mean 8.6/10, standard deviation [SD] 2).
  
  
  CONCLUSIONS
  Patients with advanced cancer and unmet symptom and psychological/emotional needs perceive a high need for subspecialty palliative care services but may not request them. Efforts to increase appropriate use of subspecialty palliative care for cancer may require oncologist-initiated referrals.
authors.affiliation: 1 Section of Palliative Care and Medical Ethics , Pittsburgh, Pennsylvania.
authors.forename: Yael
authors.initials: Y
authors.lastname: Schenker
authors.forename: Seo Young
authors.initials: SY
authors.lastname: Park
authors.forename: Rachael
authors.initials: R
authors.lastname: Maciasz
authors.forename: Robert M
authors.initials: RM
authors.lastname: Arnold
mesh_terms: D002173:Cancer Care Facilities; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D010166:Palliative Care / Q000523:psychology* / Q000592:standards; D057240:Patient Preference / Q000523:psychology*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012944:Social Support