R37CA246565

Determinants of Palliative Care Effectiveness for Patients with Metastatic Cancer - Project Summary

Palliative care is an interdisciplinary model of care with the overarching goal of improving the quality of life for patients with serious illness through symptom management, provision of psychosocial support, elicitation of preferences, and aiding decision-making. Prior studies have demonstrated that specialist palliative care is associated with decreases in treatment intensity and improvements in quality of life. However, these studies have also suggested that existing heterogeneity among palliative care teams may be associated with variability in their effectiveness.

Early integration of specialist palliative care for patients with advanced cancer has been recommended by the American Society of Clinical Oncology. However, as hospitals race to implement palliative care programs to meet these guidelines, there is little evidence to guide them as to which ingredients are necessary for effective care delivery.

The proposed research aims to target this important knowledge gap by:

1) Quantifying the association between the use of specialist palliative care and end-of-life quality metrics in cancer care.

2) Examining whether differences in specialist palliative care implementation, as measured by key variables reflecting team attributes and operational characteristics, are associated with improvements in quality metrics.

3) Using qualitative research methods to understand how programs operationalize care delivery within different hospital settings.

This project will create and utilize a novel data source that combines nationwide patient and hospital-level data, detailed data on palliative care programs, and valid information on receipt of specialist palliative care. Quantitative analyses of this unique dataset will be followed by in-depth site visits to six select palliative care programs. Together, these data will be used to develop an actionable roadmap that may be used to refine existing palliative care programs and inform the implementation of future programs to ensure effective delivery of palliative care for patients with cancer.

This project represents an important advance in understanding the role of palliative care specialists in cancer care. While prior work has focused on whether specialist palliative care is associated with improved outcomes, this work will focus on identifying the conditions under which specialist palliative care may achieve improved outcomes.

The Trustees Of Columbia University In The City Of New York

TO IDENTIFY CANCER RISKS AND RISK REDUCTION STRATEGIES, TO IDENTIFY FACTORS THAT CAUSE CANCER IN HUMANS, AND TO DISCOVER AND DEVELOP MECHANISMS FOR CANCER PREVENTION AND PREVENTIVE INTERVENTIONS IN HUMANS. RESEARCH PROGRAMS INCLUDE: (1) CHEMICAL, PHYSICAL AND MOLECULAR CARCINOGENESIS, (2) SCREENING, EARLY DETECTION AND RISK ASSESSMENT, INCLUDING BIOMARKER DISCOVERY, DEVELOPMENT AND VALIDATION, (3) EPIDEMIOLOGY, (4) NUTRITION AND BIOACTIVE FOOD COMPONENTS, (5) IMMUNOLOGY AND VACCINES, (6) FIELD STUDIES AND STATISTICS, (7) CANCER CHEMOPREVENTION AND INTERCEPTION, (8) PRE-CLINICAL AND CLINICAL AGENT DEVELOPMENT, (9) ORGAN SITE STUDIES AND CLINICAL TRIALS, (10) HEALTH-RELATED QUALITY OF LIFE AND PATIENT-CENTERED OUTCOMES, AND (11) SUPPORTIVE CARE AND MANAGEMENT OF SYMPTOMS AND TOXICITIES. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO STIMULATE TECHNICAL INNOVATION, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, AND FOSTER PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS.

93.393 - Cancer Cause and Prevention Research

National Cancer Institute (NCI) [HHS - NIH]

New York United States

State-Wide

Method to Extend Research in Time (MERIT) Award Extension Request (Type 4 Clinical Trial Optional) (PAR-21-138)

Amendment Since initial award the End Date has been extended from 01/31/26 to 01/31/28 and the total obligations have increased 375% from $689,994 to $3,274,064.