A Comparison of Palliative Care Perceptions across Metastatic Spine Patients and the General Population

Introduction: Palliative care consultation is recommended for patients with severe or terminal illnesses and demonstrates significant benefits to quality of life. Despite this, palliative care utilization is low for patients with metastatic disease. Several hypotheses attempt to explain these findings, including poor public awareness and cultural and social barriers about pain and dying. Therefore, this study aims to assess perceptions of palliative care in the spine oncology population.

Methods: The Health Information National Trends Survey 5 is a validated dataset created by the national cancer institute and was utilized to provide information on palliative care perceptions for the general population between February and June of 2020. This study involves a prospective review of MS patient palliative care perceptions assessed through a RedCap Survey. Average response scores were calculated using a codified numeric scale (1 = Strongly agree, 2 = Slightly agree, 3 = Don’t know, 4 = Slightly disagree, 5 = Strongly disagree) to assess the degree to which participants agreed with statements about palliative care.

Results: The two populations were demographically similar in Gender (Chi-Squared = 1.3, p = 0.254), Highest Level of Education (Chi-Squared = 4.75, p = 0.447), and Median age at cancer diagnosis (55 vs 60). In our misconception analysis we calculated average response scores (ARS) when we asked patients if “When they think of palliative are, they automatically think of death” (MS(ARS: 3.42,CI:[3.2-3.64]), GP(ARS:2.91,CI:[2.69-3.13])) and “If they thought palliative care was the same as Hospice care” (MS (ARS:3.28,CI:[3.04-3.52]),GP(ARS: 3.21,CI:[2.98-3.46])).

Conclusion : Compared to the general population, the MS patients tended to have higher average response scores, indicating greater disagreement with misconception statements about palliative care. This deficit in understanding points towards additional barriers that may prevent the utilization of health services. However, further investigation is necessary to understand the relationship between patient perceptions and utilization of health services