30 Nov Palliative Care Linked To Fewer Symptoms and Better Quality of Life
MedicalResearch.com Interview with:
Dr. Dio Kavalieratos, PhD
Assistant Professor of Medicine
Section of Palliative Care and Medical Ethics
Division of General Medicine
Institute of Clinical Research
University of Pittsburgh
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The field of palliative care has seen a dramatic surge in research and clinical implementation over the past decade. The last systematic review of palliative care trials was published in 2008. In that review, the authors reported very weak evidence for palliative care, as well as major methodological limitations in the trials that had been done to date. Since then, several landmark trials have been published, some with very compelling findings such increased survival. Therefore, an up-to-date review was in order.
There also had not previously been enough trials to perform a meta-analysis. A meta-analysis is the statistical process of combining the results of multiple trials, which gives you an overall effect for an intervention, in this case, palliative care. We were able to conduct the first meta-analysis of the effect of palliative care with three important outcomes: patient quality of life, patient symptom burden, and patient survival.
MedicalResearch.com: What should readers take away from your report?
Response: Our analyses suggest that patients who received palliative care had better quality of life and less symptoms than those patients who hadn’t received palliative care. We also saw that those who received palliative care were generally more satisfied with their care and so were their caregivers. In terms of survival, we did not find any association between palliative care and how long patients lived.
Taken all together, there is a very compelling message – that people’s quality of life and symptoms improved, their experiences with their care improved, all during what is likely one of the most difficult periods of their lives.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Increasing the availability of palliative care for anyone with a serious illness: Prior research, including our own, suggests that there are significant barriers for people to access palliative care (including lack of availability, or the stigma that palliative care is “the grim reaper service”).
Historically, palliative care has been overwhelmingly focused on individuals with cancer. However, anyone with a serious illness, be it cancer, heart failure, multiple sclerosis, or cystic fibrosis deserves high-quality, individualized care that focuses on reducing their suffering and improving their quality of life. We also need to find ways of integrating palliative care concepts in patients’ usual care experiences, so that palliative care isn’t a luxury, but a standard part of health care for those of us living with serious illness.
Additional research is also needed to develop new methods of studying how palliative care impacts people with serious illness and their caregivers. These methods need to not burden patients and caregivers who participate in this research, but these methods also need to be rigorous enough to capture what’s going on at this critical period in people’s lives.
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Association Between Palliative Care and Patient and Caregiver Outcomes
A Systematic Review and Meta-analysis
Kavalieratos D, Corbelli J, Zhang D, Dionne-Odom JN, Ernecoff NC, Hanmer J, Hoydich ZP, Ikejiani DZ, Klein-Fedyshin M, Zimmermann C, Morton SC, Arnold RM, Heller L, Schenker Y. Association Between Palliative Care and Patient and Caregiver OutcomesA Systematic Review and Meta-analysis. JAMA.2016;316(20):2104-2114. doi:10.1001/jama.2016.16840
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