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Early palliative care improved quality of life in patients with advanced-stage cancers
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Individuals with advanced-stage cancers who received early palliative care demonstrated improved quality of life and patient satisfaction compared with those who received standard oncology care, according to results of a cluster-randomized, controlled trial.
The study included 461 patients treated across 24 medical oncology clinics in the Princess Margaret Cancer Centre, University Health Network between Dec. 1, 2006, and Feb. 28, 2011. Clinics were cluster randomized in a 1:1 ratio to consultation and monthly follow-up by a palliative care team (n=228) or standard cancer care (n=233).
The cohort included patients with advanced cancer who had a clinical prognosis of 6 to 24 months, as well as ECOG performance status between 0 and 2.
Researchers measured quality of life, symptom severity, satisfaction with care and problems with medical interactions at baseline and monthly for 4 months. All 461 patients completed baseline measurements, and 393 patients completed at least one follow-up assessment.
At 3 months, researchers observed a nonsignificant difference in Functional Assessment of Chronic Illness Therapy — Spiritual Well-Being scores between the early palliative care group and standard therapy group (difference, 3.56 points; 95% CI, −0.27 to 7.40).
Researchers observed significant differences in measurements using the Quality of Life at the End of Life scale (difference, 2.25 points; 95% CI, 0.01-4.49) and FAMCARE-P16 satisfaction with care scale (difference, 3.7 points; 95% CI, 1.74-5.85).
The investigators reported no differences in measurements on the Edmonton Symptom Assessment System (95% CI, −5.26 to 1.87) or Cancer Rehabilitation Evaluation System Medical Interaction Subscale (95% CI, −2.25 to 0.94).
Camilla Zimmermann
At 4 months, results showed significant differences in scores for all measurements except the Cancer Rehabilitation Evaluation System Medical Interaction Subscale. All differences favored the early palliative care group.
“The traditional view of palliative care is end-of-life measures, but over the past 10 years, specialized palliative care has been evolving into finding ways to improve quality of life earlier on,” Camilla Zimmermann, MD, head of the palliative care program and medical director of the Al Hertz Centre for Supportive and Palliative Care at Princess Margaret Hospital, said in a press release. “Our study results can help map the way forward.”
Disclosure: The study was funded by the Canadian Cancer Society, Ontario Ministry of Health and Long Term Care.
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