What do transplant physicians think about palliative care? A national survey study

Abstract

Background: Despite its established benefits, palliative care (PC) is rarely utilized for hematopoietic stem cell transplant (HSCT) patients. We sought to examine transplant physicians’ perceptions of PC. Methods: We conducted a cross-sectional survey of transplant physicians recruited from the American-Society-for-Blood-and-Marrow-Transplantation. Using a 28-item questionnaire adapted from prior studies, we examined physicians’ access to PC services, and perceptions of PC. We computed a composite score of physicians’ attitudes about PC (mean = 16.9, SD = 3.37) and explored predictors of attitudes using a linear mixed model. Results: 277/1005 (28%) of eligible physicians completed the questionnaire. The majority (76%) stated that they trust PC clinicians to care for their patients, but 40% felt that PC clinicians do not have enough understanding to counsel HSCT patients about their treatments. Most endorsed that when patients hear the term PC, they feel scared (82%) and anxious (76%). Nearly half (46%) reported that the service name ‘palliative care’ is a barrier to utilization. Female sex (β = 0.85, P =.024), having <10 years of clinical practice (β = 1.39, P =.004), and perceived quality of PC services (β = 0.60, P