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Massey researcher awarded $140,000 to study factors affecting whether and how cancer patients utilize palliative care

Apr 03, 2019

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VCU Massey Cancer Center director of palliative care research, J. Brian Cassel, Ph.D., was recently awarded $140,000 in grant funding from the American Cancer Society (ACS) to facilitate a two-year pilot study that will explore how certain factors, including demographics and social disparities, may affect whether and how cancer patients utilize palliative care. The research findings will be translated into efforts to decrease inequities in quality of care.

Palliative care is a medical specialty focused on improving the quality of life of patients with a serious illness like cancer by managing symptoms and relieving pain and stress. Massey has been at the forefront of this approach for decades and is transforming the standards of palliative care through clinical practice, education and research.

“Palliative care provides an extra layer of support for patients with cancer,” said Cassel, also a member of Massey’s Cancer Prevention and Control research program. “Yet prior research assessing access to palliative care has critical weaknesses, which will be addressed in our community-wide study.”

Preceding investigations have demonstrated that palliative care improves cancer symptoms, reduces healthcare costs and can help patients live longer. However, little is currently known about how many cancer patients in a given community are accessing palliative care services and when in the course of their disease they are doing so. As a result, there is limited data on the association between demographics and palliative care, as well as inadequate evidence of disparities in the care that patients receive. 

To address these gaps, Cassel’s study will examine whether the usage and timing of palliative care are associated with patient characteristics, such as race, age and socio-economic status. If disparities in the quality of care are discovered, Cassel will investigate if interventions in palliative care can alleviate them. The study also aims to distinguish between the effects of palliative care and hospice care.

“This will be the first large-scale palliative care study in the U.S. to take a population-level approach,” said Cassel. “It will allow for the first-time estimation of rates and timing of specialist palliative care utilization among all cancer patients in a metropolitan area.”

For the study, Cassel will retrospectively analyze information on more than 14,000 deceased cancer patients who received palliative care in the Richmond area between 2010 and 2015. The investigation will rely on secondary data acquired from the Virginia Cancer Registry and several non-federal health systems that offer palliative care services. Another goal of the study is to demonstrate the feasibility and importance of acquiring data from disparate sources for population-based research on palliative care for cancer patients.

“This pilot project is a critical step in the development of a larger model linking social determinants of health to palliative care,” said Cassel. Cassel hopes to eventually expand the methodology to include data on cancer-directed treatments, multiple metropolitan areas or larger contiguous areas and hospice care for younger populations. Another future direction of this line of research will be to develop and apply interventions to address inequities in access to palliative care in the Richmond area.

Cassel will serve as the principal investigator on this study and will collaborate with Egidio Del Fabbro, M.D., palliative care program director and member of the Developmental Therapeutics research program at Massey as well as the Massey Endowed Chair in Palliative Care. Massey researcher Tara Albrecht, Ph.D., R.N., will also contribute as a clinical leader.

Written by: Melissa Mitchell

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