Patients With Blood Cancer Rank Transfusion Access as Most Important Hospice Service

Access to palliative blood transfusion is the most important factor influencing hospice decisions among patients with blood cancers, according to new research from investigators at Dana-Farber Cancer Institute and Yale Cancer Center. The findings were published Nov. 5 in JAMA Network Open.

In a multicenter survey, investigators asked 200 adults with a physician-estimated life expectancy of six months or less to rate the importance of routine and non-routine hospice services. Participants ranked transfusion access as the top service. Following transfusions, services that help patients connect with their care teams, such as telemedicine and transportation to appointments, were rated higher than social or spiritual support services, including peer support, social work and chaplaincy.

Additionally, an exploratory analysis by transfusion dependence showed that patients who received more than one transfusion in the 30 days before the survey ranked transfusion access as their top service, whereas those with one or fewer transfusions ranked telemedicine as most important, followed by transfusion access.

According to the researchers, participants’ prioritization of transfusion access suggests that ensuring availability of blood and platelet transfusions is a key factor in hospice decision-making for this patient population. However, they noted that operationalizing hospice transfusion access is limited by current payment structures. They suggest that innovative hospice models incorporating transfusions, alongside new payment approaches, may be necessary to better align hospice services with the needs of this population.