Palliative care focused on advanced care planning, coping, and treatment decisions are associated with improved outcomes among patients with advanced cancer, according to a study published in the Journal of Clinical Oncology.
Although the results of numerous studies, reviews, and clinical trials demonstrate that palliative care improves various end-of-life outcomes, the content and nature of palliative care has not been fully elucidated.
To evaluate the focus of palliative care, researchers prospectively assessed the data from 2921 palliative care visits of 171 patients with newly diagnosed advanced lung or noncolorectal gastrointestinal cancer. Study patients had at least monthly visits, and palliative care physicians completed surveys detailing each visit; visit content was summarized over time and analyzed to determine any associations between content and patient-reported outcomes. Patients completed self-report quality of life (QoL) and mood questionnaires at baseline and at 24 weeks.
Most patient visits emphasized coping (64.2%) and symptom management (74.5%).
Results showed that patients who had more visits focused on coping experience had improvements in QoL (P =.02) and depression symptoms as assessed by the PHQ-9 (P =.002), and patients whose care emphasized treatment decisions were less likely to be hospitalized (P =.005) or initiate chemotherapy 2 months prior to death (P =.02). Patients who had more visits based on advance care planning were more likely to use hospice care (P =.03).
The authors concluded that “this study defines the key elements of early [palliative care] for patients with advanced cancer and provides a roadmap for building outpatient [palliative care] practices to enable dissemination of this care model.”
Hoerger M, Greer JA, Jackson VA, et al. Defining the elements of early palliative care that are associated with patient-reported outcomes and the delivery of end-of-life care [published online February 23, 2017]. J Clin Oncol. doi: 10.1200/JCO.2017.75.6676