Table 2.
Comparison of frequency, definition, and timing for palliative care involvement in NCCN guidelines for treatment of cancer
| Characteristics of Palliative Care Recommendation | Solid tumor NCCN guidelines, n = 37 | Hematologic NCCN guidelines, n = 16 |
|---|---|---|
| Number of times “palliative care” was mentioned,median (IQR); primary outcome | 2 (0–6) a | 0 (0–2) a |
| “Palliative care” term present, n (%) | 24 (65) | 6 (38) |
| Definition of “palliative care” provided, b n (%) | 20 (83) | 5 (83) |
| Section to explain palliative, care b n (%) | 2 (8) | 0 (0) |
| Specialist palliative care referral/consultation, b n (%) | 4 (17) | 1 (17) |
| Timing for palliative care involvement, c n (%) | ||
| First line | 14 (58) | 2 (33) |
| Recurrent, relapse, refractory, progression | 12 (50) | 5 (83) |
| Others d | 7 (29) | 1 (17) |
| Solid ‐ localized disease | 2 (8) |
p = .04.
Among the guidelines that mentioned palliative care.
Among the guidelines that mentioned palliative care. Some guidelines discussed palliative care involvement on more than one occasion, and thus the total percentage was greater than 100%.
Other timing for palliative care involvement included (a) poor physical status, (b) patients who do not desire further therapy, (c) symptom management (i.e., pain, dysphagia, obstruction, pain, bleeding, nausea/vomiting), (d) end‐organ status and preexisting toxicities from prior regiments, and (e) when establish goal of therapy (i.e., discuss palliative care option).
Abbreviations: IQR, interquartile range; NCCN, National Comprehensive Cancer Network.