The ESMO Designated Centres (ESMO-DCs) of Integrated Oncology and Palliative Care (PC) Incentive Programme has grown steadily and now includes 180 centres in 40 countries. We conducted a survey to determine the characteristics and level of integration of PC services at ESMO-DCs.
An electronic survey was sent to leaders of all ESMO-DCs between April and May 2016. The survey consisted of 78 questions examining the DC characteristics, palliative care clinical programme (structure, processes, outcomes), education, research and attitudes and beliefs toward the ESMO-DC programme. The level of integration was assessed based on 13 criteria developed from a Delphi survey (Hui et al. Ann Oncol 2015).
The response rate was 77% (139/180). 105 (76%) ESMO-DCs were from Europe, 50 (36%) were tertiary care cancer centres and 30 (22%) were tertiary care general hospitals. The median number of beds was 550 (interquartile range [IQR] 277-925). 131 (94%) had inpatient consultation teams, 106 (76%) had outpatient palliative care clinics, 88 (63%) had dedicated acute care beds, and 75 (54%) offered community-based PC. 132 (95%) had an interdisciplinary team, and 90 (65%) had dually certified palliative oncologists. These programmes reported that a median of 70% (IQR 28-80%) of patients with advanced cancer had a PC consultation before death. The estimated median time between PC consultation and death was 60 days (IQR 14-120 days) for outpatients and 20 days (IQR 10-42 days) for inpatients. In regard to education, 55 (40%) offered PC fellowship programmes; 43 (31%) had mandatory PC rotations for oncology fellows; 71 (51%) offered didactic PC curriculum for oncology fellows; 102 (73%) offered combined educational activities; and 104 (75%) provided continuing medical education for oncologists. All ESMO-DCs reported PC research activity in the past 3 years, with pain being the most common topic (N = 99, 71%). Most centres (>80%) perceived the ESMO-DC programme to increase their status.
The ESMO-DCs had high level of PC infrastructure and provided PC access to a large proportion of patients with advanced cancer. Areas for improvement include timing of referral, clinical processes of integration and educational components.
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All authors have declared no conflicts of interest.