"Triggers Tool" Gets Patients Into Palliative Care Earlier

A new tool is helping healthcare providers determine who will benefit from palliative care starting early in the course of their treatment for cancer, according to the authors of a pilot study whose results were presented Sept. 9, during the 2017 European Society for Medical Oncology (ESMO) Congress in Madrid, Spain.

The “Triggers” tool was developed by the London Cancer Alliance and is currently being piloted at the Royal Marsden NHS Foundation, a cancer treatment center in London. Health care professionals can assess the needs of their patients and determine if they are a good fit for palliative care, to be given alongside active treatment.

While many people associate the strategy with the end of life, studies have shown that employing palliative care earlier in the course of treatment can benefit patients’ outcomes and quality of life.

This was the case for one woman who was diagnosed with lung cancer in April of 2017 and then, thanks to the Triggers tool at Royal Marsden, was referred to palliative care. “I was referred to the palliative care team around a fortnight after arriving at The Royal Marsden. They have helped me with medication — which has given me more energy — visited me at home, and have been able to advise me about different symptoms. I definitely feel that I can call them if I need them,” she said in a press release issued by ESMO.

Those involved in the study were pleased with the results.

“It is a pleasure to read about these observations,” said Matti Aapro, MD, an ESMO faculty member and chair of the Supportive/Palliative Care Track at the ESMO 2017 Congress. “The concepts of supportive and palliative care are about a continuum in patient care, and need to be given more importance — even in these days of exciting results about new therapies.”

Of the patients who piloted the Triggers tool, 75 percent tested positive for at least one of the parameters used to assess the need for palliative care. Of this positive group, 97 percent were identified as having a moderate need, at the very least, for palliative care. Of those patients, 81 percent were referred to palliative care even though they were functioning well — a trend that, according to leaders of the pilot program, can help shift the way people perceive this supportive strategy.

“This tells us that we are addressing a real need, and that the tool is picking up a group of patients who have a real potential to benefit from referral to specialist palliative care. The goal is for the tool to become standard and easy for anyone on a patient’s primary-care team to use — for us, the next step will be to expand into other tumor groups,” said the leader of the investigation, Jayne Wood, MBBS, FRCP, of The Royal Marsden NHS Foundation Trust.