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Abstract Details

Timing and Utilization of Inpatient Palliative Care Consultation in People with High-Grade Glioma
Pain
P1 - Poster Session 1 (8:00 AM-9:00 AM)
12-008

Determine timing of palliative care consultation among adults with high-grade glioma (HGG).
The American Society for Clinical Oncology (ASCO) recommends palliative care referral within 8 weeks of advanced cancer diagnosis. Patients with HGG have substantial palliative care needs.
Adults with WHO Grade III or IV glioma between 8/3/2011 and 1/23/2020 were identified retrospectively from a large academic health system cancer registry. Patients were stratified by inpatient palliative care consultation (yes/no) and compared on demographic and tumor characteristics using chi-square or t-test as appropriate. Timing of consultation was categorized by disease phase: diagnosis (prior to chemotherapy), treatment (between first and last chemotherapy), and end-of-life (after chemotherapy). 
Of 646 patients (median age 60, female 44.9%), 99 (15.3%) received an inpatient palliative care consult (outpatient palliative care data were not available). Frequency of palliative care consultation did not differ by age, sex, or race (all p>0.05). Occurrence of consultation by tumor type were (no palliative care consult vs palliative care consult): anaplastic astrocytoma 65 (11.9%) vs 9 (9.1%), anaplastic oligodendroglioma 36 (6.6%) vs 1 (1.0%), glioblastoma 446 (81.5%) vs 89 (89.9%); p=0.05. Occurrence of consultation by tumor location were (no palliative care consult vs palliative care consult): supratentorial 437 (79.9%) vs 72 (72.7%), infratentorial 6 (1.1%) vs 4 (4.0%), other/unknown 104 (19.0%) vs 23 (23.2%); p=0.05.  Of 78 patients receiving a palliative care consult and having complete treatment data, median (IQR) time from diagnosis (biopsy) to consult was 203 (30, 395) days with 10.3% referred in the diagnostic phase, 30.8% referred in the treatment phase, and 59.0% referred in the end-of-life phase. 

Most patients with HGG did not receive inpatient palliative care consultation; the majority of referrals appeared to be beyond the ASCO-recommended time frame. This may lead to missed opportunities to improve quality of care in HGG.

Authors/Disclosures
Caroline Crooms, MD, MPH (Mount Sinai Hospital)
PRESENTER 		Dr. Crooms has nothing to disclose.
Nathalie Jette, MD, MSc, FRCPC, FAAN (University of Calgary) Dr. Jette has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for ILAE Epilepsia. The institution of Dr. Jette has received research support from NIH. The institution of Dr. Jette has received research support from AES.
Rachelle Hornick (The Mount Sinai Hospital) No disclosure on file
Parul Agarwal Parul Agarwal has nothing to disclose.
Jennie W. Taylor, MD (University of California, San Francisco) Dr. Taylor has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Servier. The institution of Dr. Taylor has received research support from BMS. The institution of Dr. Taylor has received research support from Servier. The institution of Dr. Taylor has received research support from Navio. Dr. Taylor has received research support from University of Colorado. Dr. Taylor has received research support from Mt Sinai University . Dr. Taylor has received publishing royalties from a publication relating to health care.
Nathan Goldstein No disclosure on file
Barbara G. Vickrey, MD, MPH, FAAN (Icahn School of Medicine) The institution of Dr. Vickrey has received research support from NIH. Dr. Vickrey has received personal compensation in the range of $0-$499 for serving as a Grant reviewer, committee co-chair with NIH. Dr. Vickrey has received personal compensation in the range of $0-$499 for serving as a conference advisory committee with University of Rochester. Dr. Vickrey has a non-compensated relationship as a Second Vice President with Association of University Professors of Neurology that is relevant to AAN interests or activities. Dr. Vickrey has a non-compensated relationship as a Nominating Committee member of Stroke Council with American Heart Association that is relevant to AAN interests or activities. Dr. Vickrey has a non-compensated relationship as a Nominating Committee Chair with American Neurological Association that is relevant to AAN interests or activities.