4.5 Article

Single early palliative care intervention added to usual oncology care for patients with advanced cancer: A randomized controlled trial (SENS Trial)

Journal

PALLIATIVE MEDICINE
Volume 35, Issue 6, Pages 1108-1117

Publisher

SAGE PUBLICATIONS LTD
DOI: 10.1177/02692163211005340

Keywords

Neoplasms; randomized controlled trial; advance care planning; interdisciplinary health team; integration of palliative care

Funding

  1. Swiss National Science Foundation (SNSF) within the National Research Program NRP 67 End of Life [4067-40_145088]

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This study aimed to investigate the impact of early palliative care on stress and quality of life in patients with advanced cancer. The results showed that the early palliative care intervention did not significantly improve patient distress or health-related quality of life. Therefore, patients may require more intensive early palliative care with continuous professional support to address their palliative needs early.
Background: International oncology societies recommend early palliative care. Specific models to integrate early palliative care efficiently into clinical practice are debated. The authors designed a study to look at the quantitative and qualitative outcomes of an early palliative care intervention in oncological care to decrease stress and improve quality of life. Aims: To compare a single structured early palliative care intervention added to a usual oncology care in terms of distress and health-related quality of life at baseline compared to 6 months after enrollment. Design: This multicenter randomized controlled trial (NCT01983956) enrolled adult patients with advanced cancer. Participants were either randomly assigned to usual oncology care alone or usual care plus a structured early palliative care intervention. Setting/participants: One hundred fifty adult patients with a variety of advanced cancer diagnoses were randomized. Seventy-four participants were in the intervention and 76 participants in the control group. The primary outcome was the change in patient distress assessed by the National Comprehensive Cancer Network distress thermometer at 6 months. Health-related quality of life, the secondary outcome, was assessed by the Functional Assessment of Cancer Therapy-General Questionnaire. Results: The results showed no significant effect of the early palliative care intervention neither on patient distress nor on health-related quality of life. Conclusion: The addition of an early intervention to usual care for patients with advanced cancer did not improve distress or quality of life. Thus, patients may need more intensive early palliative care with continuous professional support to identify and address their palliative needs early.

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