From the Journals

Colorectal surgeons see barriers to optimal palliative care

 

Key clinical point: Surgeons valued palliative and end-of-life care for patients with stage IV colorectal cancer, but reported multiple barriers to implementation.

Major finding: More than three-quarters of surgeons (76.1%) reported no formal education in palliative care, and 61.8% said patients and families had unrealistic expectations.

Study details: A mixed methods study including 131 members of a surgical society (American Society of Colon and Rectal Surgeons) who submitted Internet responses to a validated survey.

Disclosures: The authors declared that no competing interests relative to this report exist.

Source: Suwanabol PA et al. J Palliat Med. 2018 Mar 13. doi: 10.1089/jpm.2017.0470.


 

FROM THE JOURNAL OF PALLIATIVE MEDICINE

While colorectal surgeons value palliative and end-of-life care, they perceive multiple barriers to its optimal implementation at the patient, family, and clinician level, results of a recent survey suggest.

“We found that surgeons reported the most important barriers to be their own,” said Pasithorn A. Suwanabol, MD, division of colorectal surgery, University of Michigan, Ann Arbor, and coauthors of a report on the survey.

More than three-quarters of surgeons said they had no formal education in palliative care, and a substantial number specifically noted inadequate training in both communication and techniques to forgo life-sustaining measures, according to the report, published in the Journal of Palliative Medicine.

Dr. Suwanabol and her colleagues sought surgeon perspectives on palliative care for stage IV colorectal cancer in part because palliative care is often not integrated with cancer treatment in these potentially incurable patients.

“Compared with patients treated by primary providers, surgical patients with terminal diseases are significantly less likely to receive palliative or end-of-life care,” they said in the report.

They conducted a mixed methods study including members of a surgical society (American Society of Colon and Rectal Surgeons) who were asked to submit Internet responses to a validated survey. This mixed methods study is believed to be the first to characterize surgeons’ perceived barriers to optimal palliative and end-of life care for patients with advanced colorectal cancer, Dr. Suwanabol and her colleagues noted.

A total of 131 surgeons responded to the survey, for a response rate of 16.5%. The majority of surgeons responding (76.1%) said they did not have any formal palliative care training, while 42.7% said they lacked specific education in communication and 37.9% lacked training in techniques to forgo life-sustaining measures.

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