Cancer Medicine (Mar 2023)

Family physicians' involvement in palliative cancer care

  • Christine C. Moon,
  • Kenneth Mah,
  • Ashley Pope,
  • Nadia Swami,
  • Breffni Hannon,
  • Jenny Lau,
  • Ernie Mak,
  • Ahmed al‐Awamer,
  • Subrata Banerjee,
  • Laura A. Dawson,
  • Amna Husain,
  • Gary Rodin,
  • Lisa W. Le,
  • Camilla Zimmermann

DOI
https://doi.org/10.1002/cam4.5371
Journal volume & issue
Vol. 12, no. 5
pp. 6213 – 6224

Abstract

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Abstract Background Family physicians' (FPs) long‐term relationships with their oncology patients position them ideally to provide primary palliative care, yet their involvement is variable. We examined perceptions of FP involvement among outpatients receiving palliative care at a cancer center and identified factors associated with this involvement. Methods Patients with advanced cancer attending an oncology palliative care clinic (OPCC) completed a 25‐item survey. Eligible patients had seen an FP within 5 years. Binary multivariable logistic regression analyses were conducted to identify factors associated with (1) having seen an FP for palliative care within 6 months, and (2) having a scheduled/planned FP appointment. Results Of 258 patients, 35.2% (89/253) had seen an FP for palliative care within the preceding 6 months, and 51.2% (130/254) had a scheduled/planned FP appointment. Shorter travel time to FP (odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.48–0.93, p = 0.02), the FP having a 24‐h support service (OR = 1.96, 95% CI = 1.02–3.76, p = 0.04), and a positive perception of FP's care (OR = 1.05, 95% CI = 1.01–1.09, p = 0.01) were associated with having seen the FP for palliative care. English as a first language (OR = 2.90, 95% CI = 1.04–8.11, p = 0.04) and greater ease contacting FP after hours (OR = 1.33, 95% CI = 1.08–1.64, p = 0.008) were positively associated, and female sex of patient (OR = 0.51, 95% CI = 0.30–0.87, p = 0.01) and travel time to FP (OR = 0.66, 95% CI = 0.47–0.93, p = 0.02) negatively associated with having a scheduled/planned FP appointment. Number of OPCC visits was not associated with either outcome. Conclusion Most patients had not seen an FP for palliative care. Accessibility, availability, and equity are important factors to consider when planning interventions to encourage and facilitate access to FPs for palliative care.

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