Systematic versus on-demand early palliative care: results from a multicentre, randomised clinical trial

Abstract

Systematic EPC in advanced pancreatic cancer patients significantly improved QoL with respect to on-demand EPC.

Improving patient and caregiver outcomes in oncology: Team‐based, timely, and targeted palliative care

“…In this section, we focus on more recent publications, because older studies have been summarized in previous reviews . Table highlights the key elements of study design and outcomes . A majority of these clinical trials concluded that concurrent palliative care improves quality of life, symptoms, and patient‐clinician communication compared with oncologic care alone .…”

“…Furthermore, palliative care has not yet been accredited in some countries, which may contribute further to inconsistencies in its delivery. As shown in Table , it appears that studies involving interdisciplinary palliative care teams were more likely to have a positive outcome than those involving nurse‐led palliative care (4 of 5 trials vs 2 of 6 trials for the primary outcome) . However, to date, no single study has directly compared interdisciplinary teams with single‐practitioner–led models, and further research is needed.…”

“…There is strong evidence demonstrating the benefits of stand‐alone clinics (Table ) . Patients whose initial palliative care contact was in these clinics have improved outcomes related to aggressiveness of care at the end of life (characterized by fewer prolonged hospitalizations, intensive care unit admissions, and emergency department visits in the last month of life and lower rates of in‐hospital death) compared with patients seen by the palliative care team as inpatients .…”

“…This model was feasible and acceptable to patients, families, and oncologists; a cluster RCT of this intervention is ongoing . Of note, care delivered by oncology teams alone was the control arm in several RCTs demonstrating improved quality of life when a palliative care team was also involved . In one of those trials, patients perceived clear differences in the focus (disease vs person/family), motive (managing cancer treatment vs managing symptoms), and model of care (physician‐led, time‐constrained vs patient‐led, flexible) in oncology versus palliative care clinics .…”

Barriers to the early integration of palliative home care into the disease trajectory of advanced cancer patients: A focus group study with palliative home care teams

“…Recent studies have shown that the early provision of specialist palliative care (PC) concurrent with active oncology care has beneficial effects on the quality of life and mood of the patient and the family caregiver (Bakitas et al, ; Maltoni et al, ; Temel et al, ; Zimmermann et al, ) and even on survival (Bakitas et al, ; Temel et al, ).…”