Published Online: February 21, 2014
A 4-year study assessing the impact of early outpatient palliative care versus standard oncology care in a variety of advanced cancers found promising results. The researchers observed that when palliative care teams collaborated earlier in the course of illness, it improved patients’ quality of life and satisfaction.
“The traditional view of palliative care is end-of-life measures, but over the past 10 years, specialized palliative care has been evolving into finding ways to improve quality of life earlier on. Our study results can help map the way forward,” says
Camilla Zimmermann, MD, PhD, FRCPC, head, Palliative Care Program, University Health Network. “The key outcome validates that quality of life improves with the core intervention of seeing a physician and nurse with specialist palliative care training once a month in the outpatient clinic.”
The study included nearly 500 patients with advanced lung, gastrointestinal, genitourinary, breast, and gynecologic cancers whose prognosis was greater than 6 months. Early intervention entailed formal monthly consultations with the palliative care team, as well as telephonic follow-up. Patients were also given extensive palliative consultation services and offered the opportunity to continue follow-up in outpatient palliative care clinics.
“Quality of life was an outcome of interest because it is a central focus of palliative care,” says Dr Zimmermann. “The research team used a cancer-specific measure encompassing physical, function, social, and psychological domains, as well as the spiritual domain, which is of particular relevance in patients with advanced cancer,” she explains.
Amy Berman, BS, RN, who recently presented
at The American Journal of Managed Care
’s Patient-Centered Oncology meeting in November 2013, said that palliative care is a crucial asset in oncology treatment.
“People actually do live longer when you focus on pain and symptoms and quality of life,” Ms Berman says. “Oncology chooses to look in a narrow way at the cancer, and we have to begin addressing the person.”
Berman’s presentation supports the study findings, saying that palliative care functions as an “extra layer” of support. Offering it at the onset of a cancer diagnosis, rather than at the end of life, will bring cost savings and greater quality of life.
“For those of you who are in the managed care environment, in ACOs, working under new patient methodologies, you have the ability to offer it all to your patients. If you are in a capitated environment, you will benefit from this. It will reduce liability,” she said.
Around the Web
Cancer Study Shows Earlier Palliative Care Improves Quality of Life, Patient Satisfaction [Medical Xpress]