Hospice use was compared between both groups at 180 days, and although the palliative care group utilized hospice more (28%) than the usual care group (25%), the difference was not statistically significant. The use of the intensive care unit was also not statistically different between the 2 groups.

Survival time at 1 year after enrollment was longer in the palliative care group (41 of 69 patients died) compared to the usual care group (44 of 67 patients died). Palliative care patients lived almost 5 months longer than those in the usual care group did, although the difference did not prove to be statistically significant because of the highly variable length of survival within the patient cohort.

In summary, the researchers found that enrolling patients with advanced cancer into early palliative care intervention upon entry into the ED made a significant difference in the patient’s QOL. The researchers emphasized that this was a diverse group in terms of the type of cancer the patients had, as well as their race, ethnicity, and socioeconomic status. Despite these differences, the QOL among the patients in the palliative care group was markedly improved. They conclude that their findings about the benefits of early palliative intervention are not only critical to patients, but are also important to those in the health care community who can initiate palliative care earlier in the course of a patient’s disease.

References

1. Zimmermann C, Swami N, Krzyzanowska M, et al. Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. Lancet. 2014;383(9930):1721-1730.

2. Strand JJ, Kamdar MM, Carey EC. Top 10 things palliative care clinicians wished everyone knew about palliative care. Mayo Clin Proc. 2013;88(8):859-865.

3. Osta BE, Palmer JL, Paraskevopoulos T, et al.  Interval between first palliative care consult and death in patients diagnosed with advanced cancer at a comprehensive cancer center. J Palliat Med. 2008;11(1):51-57.

4. Grudzen CR, Richardson LD, Johnson PN, et al. Emergency department–initiated palliative care in advanced cancer: a randomized clinical trial [published online ahead of print January 14, 2016]. JAMA Oncol. doi: 10.1001/jamaoncol.2015.5252.