The utilization of palliative care services by patients with glioblastoma: A cross-sectional study with care partners of patients with GBM recruited from Facebook support groups.

Abstract

2076 Background: Glioblastoma(GBM) is a terminal brain cancer that has a rapid onset and results in symptoms such as headaches, vomiting, seizures, anxiety, depression, agitation, speech impairment, memory impairment, infections, brain bleeds, mobility changes, changes in sleep patterns and cognitive changes. Palliative care helps patients diagnosed with an incurable or chronic disease manage physical, social and psychological symptoms while undergoing treatment, and has been shown to increase survival for patients with cancer. Previous data of former care partners of patients with GBM indicated only 30% of patients used palliative care during the disease trajectory, whereas 90% engaged hospice during the end of life stage. Methods: To better understand the reasons for underutilization of palliative care, primary caregivers of patients with GBM recruited from a Facebook support group in February 2024 completed a 38-question survey about where care was received, who was on their care team, and whether they had discussions around palliative care. Inclusion criteria: current primary care partner of a patient with GBM over the age of 18, and willing to participate (IRB exempt;H24-0393). The care partner was excluded if their patient was no longer living. Results: Of the 77 care partners who participated in the study, the median age of the caregivers was 56 years (98% female) and the median age of the patients with GBM was 60 years (87% female). Patients with GBM were initially diagnosed in community hospitals, major medical centers, university medical centers, brain tumor centers, and as part of incidental findings. Approximately ¼ of patients pursued second opinions. Of the 21 patients initially diagnosed in community medical centers, over half received treatment in other facilities. Medical care team members differed by facility type with a marked difference in palliative care utilization. Only 27% of care partners reported palliative care was part of the care team. Notably,when care team members discussed palliative care with patients and their care partners (n = 21), 71% of the dyads utilized palliative care. In contrast, when palliative care was not discussed (n = 56), only 7% of the care partners used these services (p < 001). Participants reported they would have benefited from additional supportive services provided by patient navigation and palliative care. Conclusions: This data highlights the value of discussions about palliative care in its utilization among GBM patients and their care partners. These conversations should take place early in the disease's progression to ensure that care partners receive the necessary education and resources in a timely manner.