Oncologists should be open to implementing the TEAM approach to provide their patients the best concurrent palliative care possible, Thomas J. Smith, MD, FACP, FASCO, FAAHPM, professor of medicine and epidemiology, University of Pennsylvania, Philadelphia, PA.
The TEAM approach to palliative care is comprised of:
Time: In all, there are 13 randomized, controlled trials comparing usual oncology care to usual oncology care plus palliative care. According to Dr. Smith, the first patient visit by the team will take about 1 hour, followed by 30-to-45-minute visits each month with the patient. Most oncologists, he added, do not have the time to do that for each patient.
Education: Oncologists must educate themselves on symptom management and advanced care planning.
Assessments: Conduct formal assessments using the Edmonton Symptom Assessment Scale or the Memorial Symptom Assessment Scale. The point, according to Dr. Smith, is to do formal assessments to understand what is bothering the patient.
Management: Have a management plan, said Dr. Smith. Having a team is also helpful. Patient needs can run the gamut from spiritual and existential, to the more physical needs, such as neuropathy and home care.
“I would encourage oncology practices to reach out to their palliative care in their community, see if they can find a willing partner, and then work with them on some specific things,” said Dr. Smith.
“If you have another team—doc, advanced practice nurse, social worker, chaplain, or some components thereof—to help figure out what is bothering the patient and fix it, it’s going to be good for everybody,” he concluded.