Lay Health Workers Can Improve End-of-Life Cancer Care
TUESDAY, July 31, 2018 -- Incorporating lay health workers (LHWs) into cancer care increases documentation of goals of care, and can improve patient satisfaction and reduce health care use at the end of life, according to a study published online July 26 in JAMA Oncology.
Manali I. Patel, M.D., M.P.H., from Stanford University School of Medicine in California, and colleagues conducted a randomized clinical trial among 213 patients with stage 3 or 4 recurrent cancer. Patients were randomly allocated to either a six-month program with a LHW trained to assist with establishing end-of-life care preferences or usual care.
The researchers found that patients randomized to the intervention had greater documentation of goals of care than the control group within six months of enrollment (92.4 versus 17.5 percent), and larger increases in satisfaction with care on the "satisfaction with provider" item of the Consumer Assessment of Health Care Providers and Systems (difference-in-difference, 1.53). There was no difference between the groups in the number of patients who died within 15 months of enrollment (57.1 versus 55.6 percent). Patients in the intervention group had significantly greater hospice use, fewer emergency department visits, fewer hospitalizations, and lower costs than those in the control group in the 30 days before death.
"Incorporating an LHW into cancer care increases goals-of-care documentation and patient satisfaction and reduces health care use and costs at the end of life," the authors write.
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Posted: July 2018