Early integration of palliative care services with standard oncology care for patients with advanced cancer.
TLDR
In this article, the rationale and evidence base for this model of early palliative care services integrated into standard oncology care are presented, and the implications and limitations of the existing data to elucidate the mechanisms by which early Palliative Care benefits patients and families; guide the dissemination and application of this model in outpatient settings; and inform health care policy regarding the delivery of high quality, cost-effective, and comprehensive cancer care are discussed.Abstract:
Scientific advances in novel cancer therapeutics have led to remarkable changes in oncology practice and longer lives for patients diagnosed with incurable malignancies. However, the myriad options for treatment have established a culture of cancer care that has not been matched with a similar availability of efficacious supportive care interventions aimed at relieving debilitating symptoms due to progressive disease and treatment side effects. Accumulating data show that the introduction of palliative care services at the time of diagnosis of advanced cancer leads to meaningful improvement in the experiences of patients and family caregivers by emphasizing symptom management, quality of life, and treatment planning. In this review article, the rationale and evidence base for this model of early palliative care services integrated into standard oncology care are presented. In addition, the implications and limitations of the existing data to 1) elucidate the mechanisms by which early palliative care benefits patients and families; 2) guide the dissemination and application of this model in outpatient settings; and 3) inform health care policy regarding the delivery of high-quality, cost-effective, and comprehensive cancer care are discussed.read more
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CA : A Cancer Journal for Clinicians
Patrizia Agostinis,Kristian Berg,Keith A. Cengel,Thomas H. Foster,Albert W. Girotti,Sandra O. Gollnick,Stephen M. Hahn,Michael R. Hamblin,Asta Juzeniene,David Kessel,Mladen Korbelik,Johan Moan,Pawel Mroz,Dominika Nowis,Jacques Piette,Brian C. Wilson,Jakub Golab +16 more
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An integrated palliative and respiratory care service for patients with advanced disease and refractory breathlessness: a randomised controlled trial.
Irene J Higginson,Claudia Bausewein,Claudia Bausewein,Charles C. Reilly,Wei Gao,Marjolein Gysels,Marjolein Gysels,Mendwas Dzingina,Paul McCrone,Sara Booth,Caroline J. Jolley,John Moxham +11 more
TL;DR: The findings provide robust evidence to support the early integration of palliative care for patients with diseases other than cancer and breathlessness as well as those with cancer.
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Markus W. Haun,Stephanie Estel,Gerta Rücker,Hans-Christoph Friederich,Matthias Villalobos,Michael Thomas,Mechthild Hartmann +6 more
TL;DR: Compared with usual/standard cancer care alone, early palliative care significantly improved health-related quality of life at a small effect size, and survival among adults with a diagnosis of advanced cancer.
References
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Journal ArticleDOI
Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer
Jennifer S. Temel,Joseph A. Greer,Alona Muzikansky,Emily R. Gallagher,Sonal Admane,Vicki A. Jackson,Constance Dahlin,Craig D. Blinderman,Juliet Jacobsen,William F. Pirl,J. Andrew Billings,Thomas J. Lynch +11 more
TL;DR: Among patients with metastatic non-small-cell lung cancer, early palliative care led to significant improvements in both quality of life and mood and, as compared with patients receiving standard care, patients received less aggressive care at the end of life but longer survival.
CA : A Cancer Journal for Clinicians
Patrizia Agostinis,Kristian Berg,Keith A. Cengel,Thomas H. Foster,Albert W. Girotti,Sandra O. Gollnick,Stephen M. Hahn,Michael R. Hamblin,Asta Juzeniene,David Kessel,Mladen Korbelik,Johan Moan,Pawel Mroz,Dominika Nowis,Jacques Piette,Brian C. Wilson,Jakub Golab +16 more
Journal ArticleDOI
Factors Considered Important at the End of Life by Patients, Family, Physicians, and Other Care Providers
Karen E. Steinhauser,Nicholas A. Christakis,Elizabeth C. Clipp,Maya McNeilly,Lauren M. McIntyre,James A. Tulsky +5 more
TL;DR: Although pain and symptom management, communication with one's physician, preparation for death, and the opportunity to achieve a sense of completion are important to most, other factors important to quality at the end of life differ by role and by individual.
Journal ArticleDOI
Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment.
Alexi A. Wright,Baohui Zhang,Alaka Ray,Jennifer W. Mack,E. D. Trice,Tracy A. Balboni,Susan L. Mitchell,Vicki A. Jackson,Susan D. Block,Paul K. Maciejewski,Holly G. Prigerson +10 more
TL;DR: End-of-life discussions with physicians are associated with less aggressive medical care near death and earlier hospice referrals, and Aggressive care is associated with worse patient quality of life and worse bereavement adjustment.
Journal ArticleDOI
Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies
Alex J. Mitchell,Alex J. Mitchell,Melissa Chan,Henna Bhatti,Marie Halton,Luigi Grassi,Christoffer Johansen,Nicholas Meader +7 more
TL;DR: Interview-defined depression and anxiety is less common in patients with cancer than previously thought, although some combination of mood disorders occurs in 30-40% of patients in hospital settings without a significant difference between palliative-care and non-palliatives-care settings.
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