title: Interdisciplinary Palliative Care for Patients With Lung Cancer.
abstract: BACKGROUND
  Palliative care, including symptom management and attention to quality of life (QOL) concerns, should be addressed throughout the trajectory of a serious illness such as lung cancer.
  
  
  OBJECTIVE
  This study tested the effectiveness of an interdisciplinary palliative care intervention for patients with Stage I-IV non-small cell lung cancer (NSCLC).
  
  
  METHODS
  Patients undergoing treatments for NSCLC were enrolled in a prospective, quasi-experimental study whereby the usual care group was accrued first followed by the intervention group. Patients in the intervention group were presented at interdisciplinary care meetings, and appropriate supportive care referrals were made. They also received four educational sessions. In both groups, QOL, symptoms, and psychological distress were assessed at baseline and 12 weeks using surveys which included the Functional Assessment of Cancer Therapy-Lung and the Lung Cancer Subscale, the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, and the Distress Thermometer.
  
  
  RESULTS
  A total of 491 patients were included in the primary analysis. Patients who received the intervention had significantly better scores for QOL (109.1 vs. 101.4; P < 0.001), symptoms (25.8 vs. 23.9; P < 0.001) spiritual well-being (38.1 vs. 36.2; P = 0.001), and lower psychological distress (2.2 vs. 3.3; P < 0.001) at 12 weeks, after controlling for baseline scores, compared to patients in the usual care group. Patients in the intervention group also had significantly higher numbers of completed advance care directives (44% vs. 9%; P < 0.001), and overall supportive care referrals (61% vs. 28%; P < 0.001). The benefits were seen primarily in the earlier stage patients vs. those with Stage IV disease.
  
  
  CONCLUSIONS
  Interdisciplinary palliative care in the ambulatory care setting resulted in significant improvements in QOL, symptoms, and distress for NSCLC patients.
authors: Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California, USA. Electronic address: bferrell@coh.org.
authors: Betty
authors: B
authors: Ferrell
authors: Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California, USA.
authors: Virginia
authors: V
authors: Sun
authors: Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California, USA.
authors: Arti
authors: A
authors: Hurria
authors: Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California, USA.
authors: Mihaela
authors: M
authors: Cristea
authors: Division of Thoracic Surgery, Department of Surgery, City of Hope, Duarte, California, USA.
authors: Dan J
authors: DJ
authors: Raz
authors: Division of Thoracic Surgery, Department of Surgery, City of Hope, Duarte, California, USA.
authors: Jae Y
authors: JY
authors: Kim
authors: Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California, USA.
authors: Karen
authors: K
authors: Reckamp
authors: Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California, USA.
authors: Anna Cathy
authors: AC
authors: Williams
authors: Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California, USA.
authors: Tami
authors: T
authors: Borneman
authors: Vital Research, LLC, Los Angeles, California, USA.
authors: Gwen
authors: G
authors: Uman
authors: Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California, USA.
authors: Marianna
authors: M
authors: Koczywas
mesh_terms: D016223:Advance Directives / Q000706:statistics & numerical data; D000368:Aged; D000553:Ambulatory Care / Q000379:methods / Q000706:statistics & numerical data; D002908:Chronic Disease; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000473:pathology / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods* / Q000706:statistics & numerical data; D010348:Patient Care Team; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D012017:Referral and Consultation / Q000706:statistics & numerical data; D029181:Spirituality; D013315:Stress, Psychological / Q000628:therapy; D016896:Treatment Outcome
keywords: Lung cancer; distress; interdisciplinary care; palliative care; quality of life; symptoms