Implementing Evidence-Based Palliative Care Programs and Policy for Cancer Patients: Epidemiologic and Policy Implications of the 2016 American Society of Clinical Oncology Clinical Practice Guideline Update.

IF 5.2 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Epidemiologic Reviews Pub Date : 2017-01-01 DOI:10.1093/epirev/mxw002
Sarina R Isenberg, Rebecca A Aslakson, Thomas J Smith
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Abstract

The American Society of Clinical Oncology (ASCO) recently convened an Ad Hoc Palliative Care Expert Panel to update a 2012 provisional clinical opinion by conducting a systematic review of clinical trials in palliative care in oncology. The key takeaways from the updated ASCO clinical practice guidelines (CPGs) are that more people should be referred to interdisciplinary palliative care teams and that more palliative care specialists and palliative care-trained oncologists are needed to meet this demand. The following summary statement is based on multiple randomized clinical trials: "Inpatients and outpatients with advanced cancer should receive dedicated palliative care services, early in the disease course, concurrent with active treatment. Referral of patients to interdisciplinary palliative care teams is optimal, and services may complement existing programs" (J Clin Oncol. 2017;35(1):96). This paper addresses potential epidemiologic and policy interpretations and implications of the ASCO CPGs. Our review of the CPGs demonstrates that to have clinicians implement these guidelines, there is a need for support from stakeholders across the health-care continuum, health system and institutional change, and changes in health-care financing. Because of rising costs and the need to improve value, the need for coordinated care, and change in end-of-life care patterns, many of these changes are already underway.

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为癌症患者实施循证姑息治疗计划和政策:2016年美国临床肿瘤学会临床实践指南更新的流行病学和政策影响》。
美国临床肿瘤学会(ASCO)最近召集了一个姑息关怀特设专家组,通过对肿瘤姑息关怀临床试验进行系统回顾,更新了2012年的临时临床意见。更新后的 ASCO 临床实践指南 (CPG) 的主要观点是,应将更多患者转诊至跨学科姑息关怀团队,同时需要更多姑息关怀专家和接受过姑息关怀培训的肿瘤学家来满足这一需求。以下总结声明是基于多项随机临床试验得出的:"晚期癌症住院病人和门诊病人在接受积极治疗的同时,应在病程早期接受专门的姑息关怀服务。将患者转诊至跨学科姑息关怀团队是最佳选择,姑息关怀服务可作为现有项目的补充"(J Clin Oncol.2017;35(1):96).本文探讨了 ASCO CPGs 潜在的流行病学和政策解释及影响。我们对 CPGs 的回顾表明,要让临床医生执行这些指南,需要整个医疗保健连续体的利益相关者的支持、医疗系统和机构的变革以及医疗保健融资的变化。由于成本上升、提高价值的需要、协调护理的需要以及临终关怀模式的改变,许多变革已经在进行中。
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来源期刊
Epidemiologic Reviews
Epidemiologic Reviews 医学-公共卫生、环境卫生与职业卫生
CiteScore
8.10
自引率
0.00%
发文量
10
期刊介绍: Epidemiologic Reviews is a leading review journal in public health. Published once a year, issues collect review articles on a particular subject. Recent issues have focused on The Obesity Epidemic, Epidemiologic Research on Health Disparities, and Epidemiologic Approaches to Global Health.
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