Perceptions of supportive care among patients with stage IV or recurrent cancer in a community oncology setting.

Abstract

e24078 Background: Early integration of supportive and palliative care (SC/PC) improves outcomes for patients with advanced cancer; however, patient stigma, misconceptions, and communication gaps may delay uptake. Despite strong evidence supporting early PC, patient perceptions and utilization of SC/PC remain understudied. Prior studies suggest that patients and caregivers are receptive to supportive care services, yet less likely to engage when palliative care terminology is used. Understanding patient perspectives and patterns of SC/PC utilization may inform strategies to improve access and quality of care. Methods: From June 2025 to January 2026, we conducted a prospective, multi-site survey of adults with stage IV or recurrent malignancies at Hartford HealthCare. English- or Spanish-speaking patients completed a 10–15 minute survey assessing demographics, support and advance care planning, SC/PC utilization, and perceptions of palliative care using a validated instrument. Descriptive statistics were used for analysis. Results: A total of 163 surveys were completed. Mean age (±SD) was 67.5 ± 11.8 years, and most respondents were 1–2 years from diagnosis. Overall, 74.8% reported discussing SC/PC with a healthcare provider. Across 10 available SC services, 241 instances of utilization were reported, with markedly higher use among those who discussed SC/PC (87.6%) versus those who had not (12.4%). Among patients with provider discussion, the most utilized services were nutrition (47.4%), social work (34.8%), and home care (25.5%). In contrast, patients without SC/PC discussion commonly used physical/occupational therapy (21.2%) and nutrition (12.9%), with minimal use of palliative care (0%), integrative medicine (0%), and behavioral health (6.3%). Hospice care was explained to 33.3% of patients, and 27.9% reported understanding when it may be appropriate. Reported barriers included feeling overwhelmed by information (20.8%), limited understanding of services (18.2%), and financial stress (14.2%). Median readiness to hear about PC was 4 (0–10 scale), with 26.9% reporting 0 and 13.1% reporting 10. Conclusions: SC/PC discussions between patients and healthcare providers demonstrated higher and more varied service utilization. Although engagement in SC services increased when discussed by the oncology team, overall utilization remained suboptimal and may be limited by information overload, lack of patient understanding, persistent stigma, or financial stress. Targeted patient education regarding SC/PC, along with improved coverage, may enhance readiness and utilization of SC/PC services.