JAMA : the journal of the American Medical Association
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Multicenter Study Comparative Study
Stepped Palliative Care for Patients With Advanced Lung Cancer: A Randomized Clinical Trial.
Despite the evidence for early palliative care improving outcomes, it has not been widely implemented in part due to palliative care workforce limitations. ⋯ A stepped-care model, with palliative care visits occurring only at key points in patients' cancer trajectories and using a decrement in QOL to trigger more intensive palliative care exposure, resulted in fewer palliative care visits without diminishing the benefits for patients' QOL. While stepped palliative care was associated with fewer days in hospice, it is a more scalable way to deliver early palliative care to enhance patient-reported outcomes.