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Unmet Needs of African Americans and Whites at the Time of Palliative Care Consultation.

Publication ,  Journal Article
Kamal, AH; Bull, J; Wolf, SP; Portman, D; Strand, J; Johnson, KS
Published in: Am J Hosp Palliat Care
June 2017

CONTEXT: Differences among patient populations that present to consultative palliative care are not known. Such an appreciation would inform health-care delivery tailored to unique populations. OBJECTIVES: We aimed to compare characteristics and palliative care needs of African Americans (AAs) and whites during initial palliative care consultation. METHODS: We analyzed patient-reported, clinician-entered clinical encounter data from a large, multisite community-based, nonhospice palliative care collaborative. We included first specialty palliative care consultations from January 1, 2014, to July 2, 2015, across 15 sites within the Global Palliative Care Quality Alliance registry. Demographics, disease, performance status, advance care planning, and symptom prevalence/severity were compared. RESULTS: Of 775 patients, 12.9% (N = 100) were AA. African Americans were younger (63 vs 75.4 years, P < .0001). A larger proportion of AAs had a diagnosis of cancer (45.0% vs 36.3%, P = .09) and in the hospital (71% vs 61.8%, P = .07). African Americans were more likely to have a Palliative Performance Score of 0 to 30 (35.6% vs 23.7%, P = .049). Around 50% in both racial groups were full code; slightly more than 40% had an advance directive. Nearly two-thirds in both racial groups reported 3 or more symptoms of any severity; one-third reported 3 or more moderate or severe symptoms. A larger proportion of Africans than whites reported pain of any severity (66.0% vs 56.1%, P = .06). CONCLUSION: All patients present to palliative care consultations with significant symptom and advance care planning needs. Further research is needed to identify how to deliver palliative care: earlier, in noncancer conditions, and improve pain management in AA populations.

Duke Scholars

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Published In

Am J Hosp Palliat Care

DOI

EISSN

1938-2715

Publication Date

June 2017

Volume

34

Issue

5

Start / End Page

461 / 465

Location

United States

Related Subject Headings

  • White People
  • Severity of Illness Index
  • Palliative Care
  • Needs Assessment
  • Middle Aged
  • Male
  • Humans
  • Gerontology
  • Female
  • Black or African American
 

Citation

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Kamal, A. H., Bull, J., Wolf, S. P., Portman, D., Strand, J., & Johnson, K. S. (2017). Unmet Needs of African Americans and Whites at the Time of Palliative Care Consultation. Am J Hosp Palliat Care, 34(5), 461–465. https://doi.org/10.1177/1049909116632508
Kamal, Arif H., Janet Bull, Steven P. Wolf, Diane Portman, Jacob Strand, and Kimberly S. Johnson. “Unmet Needs of African Americans and Whites at the Time of Palliative Care Consultation.Am J Hosp Palliat Care 34, no. 5 (June 2017): 461–65. https://doi.org/10.1177/1049909116632508.
Kamal AH, Bull J, Wolf SP, Portman D, Strand J, Johnson KS. Unmet Needs of African Americans and Whites at the Time of Palliative Care Consultation. Am J Hosp Palliat Care. 2017 Jun;34(5):461–5.
Kamal, Arif H., et al. “Unmet Needs of African Americans and Whites at the Time of Palliative Care Consultation.Am J Hosp Palliat Care, vol. 34, no. 5, June 2017, pp. 461–65. Pubmed, doi:10.1177/1049909116632508.
Kamal AH, Bull J, Wolf SP, Portman D, Strand J, Johnson KS. Unmet Needs of African Americans and Whites at the Time of Palliative Care Consultation. Am J Hosp Palliat Care. 2017 Jun;34(5):461–465.
Journal cover image

Published In

Am J Hosp Palliat Care

DOI

EISSN

1938-2715

Publication Date

June 2017

Volume

34

Issue

5

Start / End Page

461 / 465

Location

United States

Related Subject Headings

  • White People
  • Severity of Illness Index
  • Palliative Care
  • Needs Assessment
  • Middle Aged
  • Male
  • Humans
  • Gerontology
  • Female
  • Black or African American