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A Pilot Feasibility Study of PAL-CHW-PDAC, a Digitally Enhanced Community Health Worker-Led Intervention to Facilitate Stepped Palliative Care in Patients with Pancreatic Cancer

Year: 2026

Type: article

Abstract: ABSTRACT Background Pancreatic Ductal Adenocarcinoma (PDAC) is associated with substantial morbidity and poor quality of life (QOL). Early palliative care (EPC) has been shown to improve quality of life and reduce symptom burden in PDAC, but only a minority of PDAC patients receive it. Using three conceptual models, we developed a CHW-led intervention to help facilitate stepped PC. Objectives To evaluate the feasibility, acceptability, and preliminary effectiveness of PAL-CHW-PDAC. Design A single-center prospective single-arm pilot study Setting/Subjects Newly-diagnosed PDAC patients (n=48) were included along with their family caregivers (FCGs) Measurements Acceptability and Feasibility were defined using the RE-AIM framework and using the Acceptability of Intervention Measure. Secondary outcomes were symptom burden, quality of life, attitudes towards PC, and ACP completion. Results The median age was 69. Of those, 29 (60%) were Hispanic, 25 (52%) had metastatic PDAC, while 23 (48%) had borderline resectable/resectable PDAC at diagnosis. Four patients died before completion of the intervention, while all remaining patients completed it. Regarding acceptability, 94% of patients strongly agreed that the intervention was acceptable. Themed common responses highlighted by patients centered around the critically important role of the CHW in the process, including in appointment and referral scheduling, especially as symptoms worsened. Patient’s physical HRQoL and symptom burden improved from baseline to 12 weeks, while 83% of patients completed ACP. Conclusions The PAL-CHW-PDAC intervention was feasible and acceptable to PDAC patients and improved symptom burden. Prospective clinical trials are needed to assess the intervention’s ability to address the QOL needs of PDAC patients.

Source: Journal of Palliative Medicine

DOI: 10.1177/10966218261485724