Angelos P Kassianos1, Myria Ioannou2, Marianna Koutsantoni2, Haris Charalambous3. 1. Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK. angelos.kassianos@ucl.ac.uk. 2. Department of Psychology, University of Cyprus, Nicosia, Cyprus. 3. Bank of Cyprus Oncology Centre, Nicosia, Cyprus.
Abstract
PURPOSE: Specialized palliative care (SPC) is currently underutilized or provided late in cancer care. The aim of this systematic review and meta-analysis is to critically evaluate the impact of SPC on patients' health-related quality of life (HRQoL). METHODS: Five databases were searched through June 2016. Randomized controlled trials (RCTs) and prospective studies using a pre- and post- assessment of HRQoL were included. The PRISMA reporting statement was followed. Criteria from available checklists were used to evaluate the studies' quality. A meta-analysis followed using random-effect models separately for RCTs and non-RCTs. RESULTS: Eleven studies including five RCTs and 2939 cancer patients published between 2001 and 2014 were identified. There was improved HRQoL in patients with cancer following SPC especially in symptoms like pain, nausea, and fatigue as well as improvement of physical and psychological functioning. Less or no improvements were observed in social and spiritual domains. In general, studies of inpatients showed a larger benefit from SPC than studies of outpatients whereas patients' age and treatment duration did not moderate the impact of SPC. Methodological shortcomings of included studies include high attrition rates, low precision, and power and poor reporting of control procedures. CONCLUSIONS: The methodological problems and publication bias call for higher-quality studies to be designed, funded, and published. However, there is a clear message that SPC is multi-disciplinary and aims at palliation of symptoms and burden in line with current recommendations.
PURPOSE: Specialized palliative care (SPC) is currently underutilized or provided late in cancer care. The aim of this systematic review and meta-analysis is to critically evaluate the impact of SPC on patients' health-related quality of life (HRQoL). METHODS: Five databases were searched through June 2016. Randomized controlled trials (RCTs) and prospective studies using a pre- and post- assessment of HRQoL were included. The PRISMA reporting statement was followed. Criteria from available checklists were used to evaluate the studies' quality. A meta-analysis followed using random-effect models separately for RCTs and non-RCTs. RESULTS: Eleven studies including five RCTs and 2939 cancerpatients published between 2001 and 2014 were identified. There was improved HRQoL in patients with cancer following SPC especially in symptoms like pain, nausea, and fatigue as well as improvement of physical and psychological functioning. Less or no improvements were observed in social and spiritual domains. In general, studies of inpatients showed a larger benefit from SPC than studies of outpatients whereas patients' age and treatment duration did not moderate the impact of SPC. Methodological shortcomings of included studies include high attrition rates, low precision, and power and poor reporting of control procedures. CONCLUSIONS: The methodological problems and publication bias call for higher-quality studies to be designed, funded, and published. However, there is a clear message that SPC is multi-disciplinary and aims at palliation of symptoms and burden in line with current recommendations.
Entities:
Keywords:
Cancer; Meta-analysis; Palliative care; Quality of life; Specialized palliative care
Authors: Karen E Steinhauser; Elizabeth C Clipp; Hayden B Bosworth; Maya McNeilly; Nicholas A Christakis; Corrine I Voils; James A Tulsky Journal: Palliat Support Care Date: 2004-03
Authors: Kathleen Doyle Lyons; Marie Bakitas; Mark T Hegel; Brett Hanscom; Jay Hull; Tim A Ahles Journal: J Pain Symptom Manage Date: 2008-05-27 Impact factor: 3.612
Authors: Jessica Y Islam; Veeral Saraiya; Rebecca A Previs; Tomi Akinyemiju Journal: Int J Environ Res Public Health Date: 2021-06-04 Impact factor: 3.390
Authors: Jennifer Moye; Kelly Stolzmann; Elizabeth J Auguste; Andrew B Cohen; Casey C Catlin; Zachary S Sager; Rachel E Weiskittle; Cindy B Woolverton; Heather L Connors; Jennifer L Sullivan Journal: J Pain Symptom Manage Date: 2020-11-16 Impact factor: 5.576