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

2021 ◽  
pp. 026921632110053
Author(s):  
Steffen Eychmüller ◽  
Susanne Zwahlen ◽  
Monica C Fliedner ◽  
Peter Jüni ◽  
Daniel M Aebersold ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Advanced Cancer ◽  
Health Related Quality ◽  
Early Palliative Care ◽  
Care Intervention ◽  
Related Quality ◽  
Health Related ◽  
Oncology Care

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.

scholarly journals The ‘Cancer Home-Life Intervention’: A randomised controlled trial evaluating the efficacy of an occupational therapy–based intervention in people with advanced cancer

2018 ◽  
Vol 32 (4) ◽  
pp. 744-756 ◽  
Author(s):  
Marc Sampedro Pilegaard ◽  
Karen la Cour ◽  
Lisa Gregersen Oestergaard ◽  
Anna Thit Johnsen ◽  
Line Lindahl-Jacobsen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Controlled Trial ◽  
Health Related Quality ◽  
Home Life ◽  
Everyday Activities ◽  
Related Quality ◽  
Health Related ◽  
Randomised Controlled

Background: People with advanced cancer face difficulties with their everyday activities at home that may reduce their health-related quality of life. To address these difficulties, we developed the ‘Cancer Home-Life Intervention’. Aim: To evaluate the efficacy of the ‘Cancer Home Life-Intervention’ compared with usual care with regard to patients’ performance of, and participation in, everyday activities, and their health-related quality of life. Design and intervention: A randomised controlled trial ( ClinicalTrials.gov NCT02356627). The ‘Cancer Home-Life Intervention’ is a brief, tailored, occupational therapy–based and adaptive programme for people with advanced cancer targeting the performance of their prioritised everyday activities. Setting/participants: Home-living adults diagnosed with advanced cancer experiencing functional limitations were recruited from two Danish hospitals. They were assessed at baseline, and at 6 and 12 weeks of follow-up. The primary outcome was activities of daily living motor ability. Secondary outcomes were activities of daily living process ability, difficulty performing prioritised everyday activities, participation restrictions and health-related quality of life. Results: A total of 242 participants were randomised either to the intervention group ( n = 121) or the control group ( n = 121). No effect was found on the primary outcome (between-group mean change: −0.04 logits (95% confidence interval: −0.23 to 0.15); p = 0.69). Nor was any effect on the secondary outcomes observed. Conclusion: In most cases, the ‘Cancer Home-Life Intervention’ was delivered through only one home visit and one follow-up telephone contact, which not was effective in maintaining or improving participants’ everyday activities and health-related quality of life. Future research should pay even more attention to intervention development and feasibility testing.

scholarly journals Chemotherapy use and quality of life in cancer patients at the end of life: an integrative review

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Elham Akhlaghi ◽  
Rebecca H. Lehto ◽  
Mohsen Torabikhah ◽  
Hamid Sharif Nia ◽  
Ahmad Taheri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
End Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Palliative Chemotherapy ◽  
Palliative Therapy ◽  
Related Quality ◽  
Health Related

Abstract Background When curative treatments are no longer available for cancer patients, the aim of treatment is palliative. The emphasis of palliative care is on optimizing quality of life and provided support for patients nearing end of life. However, chemotherapy is often offered as a palliative therapy for patients with advanced cancer nearing death. The purpose of this review was to evaluate the state of the science relative to use of palliative chemotherapy and maintenance of quality of life in patients with advanced cancer who were at end of life. Materials and methods Published research from January 2010 to December 2019 was reviewed using PRISMA guidelines using PubMed, Proquest, ISI web of science, Science Direct, and Scopus databases. MeSH keywords including quality of life, health related quality of life, cancer chemotherapy, drug therapy, end of life care, palliative care, palliative therapy, and palliative treatment. Findings 13 studies were evaluated based on inclusion criteria. Most of these studies identified that reduced quality of life was associated with receipt of palliative chemotherapy in patients with advanced cancer at the end of life. Conclusion Studies have primarily been conducted in European and American countries. Cultural background of patients may impact quality of life at end of life. More research is needed in developing countries including Mideastern and Asian countries.

scholarly journals Measuring health-related quality of life in patients with advanced cancer: a systematic review of self-administered measurement instruments

2018 ◽  
Vol 27 (8) ◽  
pp. 1937-1955 ◽  
Author(s):  
Janneke van Roij ◽  
Heidi Fransen ◽  
Lonneke van de Poll-Franse ◽  
Myrte Zijlstra ◽  
Natasja Raijmakers
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Advanced Cancer ◽  
Health Related Quality ◽  
Measurement Instruments ◽  
Related Quality ◽  
Health Related

scholarly journals Health-related quality-of-life outcome measures in paediatric palliative care: A systematic review of psychometric properties and feasibility of use

2016 ◽  
Vol 30 (10) ◽  
pp. 935-949 ◽  
Author(s):  
Lucy H Coombes ◽  
Theresa Wiseman ◽  
Grace Lucas ◽  
Amrit Sangha ◽  
Fliss EM Murtagh
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Psychometric Properties ◽  
Outcome Measures ◽  
Health Related Quality ◽  
Paediatric Palliative Care ◽  
Quality Of Life Measures ◽  
Related Quality ◽  
Health Related

Background: The number of children worldwide requiring palliative care services is increasing due to advances in medical care and technology. The use of outcome measures is important to improve the quality and effectiveness of care. Aim: To systematically identify health-related quality-of-life outcome measures that could be used in paediatric palliative care and examine their feasibility of use and psychometric properties. Design: A systematic literature review and analysis of psychometric properties. Data sources: PsychInfo, Medline and EMBASE were searched from 1 January 1990 to 10 December 2014. Hand searches of the reference list of included studies and relevant reviews were also performed. Results: From 3460 articles, 125 papers were selected for full-text assessment. A total of 41 articles met the eligibility criteria and examined the psychometric properties of 22 health-related quality-of-life measures. Evidence was limited as at least half of the information on psychometric properties per instrument was missing. Measurement error was not analysed in any of the included articles and responsiveness was only analysed in one study. The methodological quality of included studies varied greatly. Conclusion: There is currently no ‘ideal’ outcome assessment measure for use in paediatric palliative care. The domains of generic health-related quality-of-life measures are not relevant to all children receiving palliative care and some domains within disease-specific measures are only relevant for that specific population. Potential solutions include adapting an existing measure or developing more individualized patient-centred outcome and experience measures. Either way, it is important to continue work on outcome measurement in this field.

Characteristics and implications of attrition in health-related quality of life studies in palliative care

2009 ◽  
Vol 23 (5) ◽  
pp. 432-440 ◽  
Author(s):  
M Ahlner-Elmqvist ◽  
K Bjordal ◽  
MS Jordhøy ◽  
S Kaasa ◽  
M Jannert
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

scholarly journals Congruence of Health-related Quality of Life Assessment between Patient-Physician and Patient-Caregiver Dyads

2020 ◽  
Author(s):  
Chia-Chun Tang ◽  
Hsi Chen ◽  
Wei-Wen Wu ◽  
Jaw-Shiun Tsai
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Weighted Kappa ◽  
Life Assessment ◽  
Rank Test ◽  
Health Related Quality ◽  
Cross Sectional ◽  
Related Quality ◽  
Health Related

Background. Exploring the congruence of health-related quality of life (HRQOL) evaluation provides valuable information regarding whether proxies can accurately reflect patient perceptions and the quality of symptom communication. It is particular important in advanced cancer population who experience poor HRQOL and have deteriorated ability to express their feeling. The main purpose of this study was to investigate the congruence of HRQOL reports between patient-physician and patient-caregiver dyads and to determine the association of variables, if any, with the congruence between dyads. Methods. This observational study with a cross-sectional design first approached physicians who provided care for patients with advanced cancer at the participating institution. Then, patients of participated physicians and their caregivers were recruited. All participants were required to independently fill out an HRQOL questionnaire during their outpatient visits. Descriptive statistics, weighted kappa, Wilcoxon signed-rank test, and linear regression were employed for data analysis. Results. A total of 52 patient-physician and 27 patient-caregiver dyads were examined. Patients suffered from considerable problems in all three HRQOL domains: symptom, functioning, and overall HRQOL. The level of agreement was moderate between the patients and caregivers and fair between the patients and physicians. A significant relationship was found between several patient-related variables and disagreement. Conclusion. This patient group experienced a compromised HRQOL, warranting immediate attention. When there are barriers to obtaining self-repot from a patient, clinicians may consider caregivers as reasonable source. Some patients with special characteristics may need additional attention because their problems may be at greater risk of being overlooked.

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