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Palliative Care for Patients With Cancer in the COVID-19 Era

Educational Objective
To understand how palliative care for patients with cancer needs to adjust during the COVID-19 pandemic
1 Credit CME

With early studies suggesting that patients with active cancer are particularly susceptible to COVID-19, the current pandemic is forcing palliative care health care professionals to better define our identity as a field.1 With social distancing requirements, should we minimize patient contact to keep our patients and ourselves safe? As a relatively new specialty, are palliative care consults a luxury that we can hold off on to avoid overburdening the medical system? Are we essential medical personnel, or not?

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: Ambereen K. Mehta, MD, MPH, Palliative Care Program, Department of Medicine, University of California, Los Angeles, 1328 16th St, Room 207, Santa Monica, CA 90404 (akmehta47@gmail.com).

Published Online: May 7, 2020. doi:10.1001/jamaoncol.2020.1938

Conflict of Interest Disclosures: Dr Smith reported receiving personal fees from serving as coeditor, Non-Pain Palliative Symptoms, UpToDate. No other disclosures were reported.

References
1.
Onder  G , Rezza  G , Brusaferro  S.   Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy  [published online March 23, 2020].  JAMA. doi:10.1001/jama.2020.4683PubMedGoogle Scholar
2.
Temel  JS , Greer  JA , Muzikansky  A ,  et al.  Early palliative care for patients with metastatic non–small-cell lung cancer.   N Engl J Med. 2010;363(8):733-742. doi:10.1056/NEJMoa1000678PubMedGoogle ScholarCrossref
3.
Meier  DE , Back  AL , Berman  A , Block  SD , Corrigan  JM , Morrison  RS .  A national strategy for palliative care.   Health Aff (Millwood). 2017;36(7):1265-1273. doi:10.1377/hlthaff.2017.0164PubMedGoogle ScholarCrossref
4.
Dow  LA , Matsuyama  RK , Ramakrishnan  V ,  et al.  Paradoxes in advance care planning: the complex relationship of oncology patients, their physicians, and advance medical directives.   J Clin Oncol. 2010;28(2):299-304. doi:10.1200/JCO.2009.24.6397PubMedGoogle ScholarCrossref
5.
Hoek  PD , Schers  HJ , Bronkhorst  EM , Vissers  KCP , Hasselaar  JGJ .  The effect of weekly specialist palliative care teleconsultations in patients with advanced cancer—a randomized clinical trial.   BMC Med. 2017;15(1):119. doi:10.1186/s12916-017-0866-9PubMedGoogle ScholarCrossref
6.
Denis  F , Basch  E , Septans  A-L ,  et al.  Two-year survival comparing web-based symptom monitoring vs routine surveillance following treatment for lung cancer.   JAMA. 2019;321(3):306-307. doi:10.1001/jama.2018.18085PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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