Patients with cancer and their families have substantial needs for care, including needs for symptom control, spiritual support, emotional and psychological support, and practical assistance. For patients with advanced cancer whose goals focus exclusively on comfort care, hospice offers a widely utilized mechanism for meeting these needs. However, hospice is not an option for patients as long as they continue to pursue disease-modifying cancer treatment. Instead, patients with cancer typically enroll in hospice very late in the course of illness. These patients, and their families, benefit from hospice services only briefly. For this reason, there is rapidly growing interest in supportive home care programs as an """"""""upstream"""""""" alternative to hospice for patients who are still seeking disease-modifying treatment. These programs are designed to meet the supportive care needs of patients with cancer and their families before they are eligible to enroll in hospice. These programs offer a promising mechanism for providing supportive care earlier in the illness course. However, it is not known what program services are most important to patients and their families. Nor is it known whether subgroups of patients and families share distinct needs for care and preferences for treatment and may thus prefer unique combinations of services. It is essential to define patients' and families' preferences about supportive home care services in order to design programs that optimally meet patients' and families' needs. The goal of this Project is to define the supportive home care services that are most valuable to patients with cancer and their families and to define subgroups of patients and families with unique priorities. ? ? ?
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| Fishman, Jessica; O'Dwyer, Peter; Lu, Hien L et al. (2009) Race, treatment preferences, and hospice enrollment: eligibility criteria may exclude patients with the greatest needs for care. Cancer 115:689-97 |
| Casarett, David; Fishman, Jessica; O'Dwyer, Peter J et al. (2008) How should we design supportive cancer care? The patient's perspective. J Clin Oncol 26:1296-301 |
