PT - JOURNAL ARTICLE AU - Sabih, Abdul Hamid AU - Laube, Robyn AU - Strasser, Simone I AU - Lim, Lynn AU - Cigolini, Maria AU - Liu, Ken TI - Palliative medicine referrals for hepatocellular carcinoma: a national survey of gastroenterologists AID - 10.1136/bmjspcare-2020-002807 DP - 2024 May 01 TA - BMJ Supportive & Palliative Care PG - e936--e944 VI - 14 IP - e1 4099 - http://spcare.bmj.com/content/14/e1/e936.short 4100 - http://spcare.bmj.com/content/14/e1/e936.full SO - BMJ Support Palliat Care2024 May 01; 14 AB - Objectives Palliative care (PC) service involvement for hepatocellular carcinoma (HCC) patients is suboptimal and little is known about the underlying reasons for this. We aimed to study clinicians’ experience and attitudes towards PC in HCC.Methods A nationwide survey was conducted of consultants/trainees recruited from the Gastroenterological Society of Australia membership directory. Clinician demographics, experience and attitudes towards PC use for HCC patients were collected.Results There were 160 participants. Most attended weekly multidisciplinary team meetings (MDTM, 60%) and had no formal PC training (71%). MDTM with PC attendance was reported by 12%. Rates of PC referral increased incrementally from BCLC 0/A to D patients but were not universal even in advanced (46%) or terminal (87%) stages. Most acknowledged PC patient discussions occurred too late (61%). Those with prior PC training were more likely to refer BCLC 0/A and B patients for early PC. Referral rates for outpatient PC were higher in respondents who attended MDTM with PC present across all BCLC stages. PC service was rated good/very good by 70%/81% for outpatients/inpatients. Barriers to PC referral included clinician-perceived negative patient associations with PC (83%), clinician-perceived patient/caregiver lack of acceptance (81%/77%) and insufficient time (70%).Conclusions PC referral for HCC patients is not universal and occurs late even in late-stage disease. Prior PC training and/or PC presence at MDTM positively influences referral practices. Barriers to PC referral are not related to quality of PC services but rather to clinician-perceived patients’ negative reactions to or lack of acceptance of PC.Data are available on reasonable request. Deidentified data from participant surveys can be made available on request to the corresponding author. This can be made available immediately after publication to researchers with a methodologically sound research proposal to perform further research.