SP-04INTERNATIONAL PATTERNS OF PALLIATIVE CARE IN NEURO-ONCOLOGY: A PHYSICIAN SURVEY OF MEMBERS OF THE ASIAN SOCIETY OF NEURO-ONCOLOGY THE EUROPEAN ASSOCIATION OF NEURO-ONCOLOGY AND THE SOCIETY FOR NEURO-ONCOLOGY

摘要

INTRODUCTION: Brain tumor patients have limited survival and suffer from high morbidity requiring specific symptom management. Specialized palliative care (PC) services have been developed to address these symptoms and provide end of life management for patients with such malignancies. Global utilization patterns of PC in neuro-oncology are unknown. METHODS: In a collaborative effort of the Society for Neuro-Oncology (SNO), the European Association of Neuro-Oncology (EANO) and the Asian Society of Neuro-Oncology (ASNO), a 22 question survey was distributed to members. An additional paper copy was distributed at the SNO meeting quality of life session (2012) and the ASNO meeting (2013). Only physician responses are included in this report. Nonparametric methods including Wilcoxon two sample and Kruskal-Wallis tests were used to assess differences in responses. Demographic information included academic degree, specialty, formal training in neuro-oncology and PC, practice patterns and geographic locations. RESULTS: 487 evaluable responses were received (Asia-Oceania (AO) 234, Europe 74, US 179). AO providers received more formal training in PC than European physicians (p = 0.0377). Provider in all 3 regions agreed on referring patients at the onset of symptoms requiring palliation, but responders from AO refer a larger total proportion of patients to PC than provider in Europe (p <0.001). US respondents were less likely to utilize PC at the point of disease onset than providers in AO (p = 0065). US provider felt more comfortable dealing with end of life issues than AO physicians (p <0.001), but more patients were referred to formal hospice care in the US than in Europe or AO (p <0.001). CONCLUSION: This is the first report describing global differences of PC utilization in neuro-oncology. Significant differences in provider training, culture, access and utilization were mainly found between AO and the US or AO and Europe. PC patterns are more similar in Europe and the US.