A systematic review and meta-analysis of randomized controlled trials of palliative care for pain among Chinese adults with cancer

Abstract

Background Pain is one of the most common symptoms that has a severe impact on quality of life and is associated with numerous psychosocial issues in cancer patients. Palliative care, which is a recent development in China, mainly focuses on symptom control and provides psychosocial support in order to improve quality of life for terminally ill patients. This meta-analysis aimed to evaluate the effects of palliative care on cancer pain in China. Methods The four most comprehensive Chinese academic databases-CNKI, Wanfang, Vip and CBM-were searched from their inception until July 2019. Medline/PubMed, Web of Science, EBSCO and internet search (Google and Google Scholar) were also searched. Randomized controlled studies assessing the effects of palliative care on cancer pain were analyzed. The pooled random-effect estimates of standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated. Subgroup analysis was conducted by moderating factors for heterogeneity. Results The present meta-analysis included 18 studies with a total of 1370 patients. The random-effect model showed a significant effect size of palliative care on cancer pain (SMD = 1.475, p < 0.001; 95% CI = 1.071–1.878). Age, pharmacological/non-pharmacological strategies and publication date could account for the heterogeneity through subgroup analysis to some extent. Conclusions Palliative care was largely effective for relieving pain among Chinese adults with cancer, indicating that an adequate system should be urgently established to provide palliative care for cancer patients in Chinese medical settings. However, given the extent of heterogeneity, our findings should be interpreted cautiously. Electronic supplementary material The online version of this article (10.1186/s12904-019-0456-z) contains supplementary material, which is available to authorized users.

Association of pain management and positive expectations with psychological distress and spiritual well‑being among terminally ill cancer patients admitted to a palliative care unit

“…Pain is probably the most common and distressing symptom in the terminal phase of cancer [ 10 , 16 ], resulting in the particularly high priority of pain management (PM) around the research and practice of PC. Our meta-analysis showed that PC was largely effective for relieving cancer pain [ 17 ]. Due to multi-factorial adverse impacts of cancer pain, the beneficial effects of PM should consider not only biomedical factors but also patients’ psychosocial and spiritual distress [ 18 ].…”

Similarities and differences between China and Sweden regarding the core features of palliative care for people aged 60 or older: a systematic scoping review

“…However, another review indicated that when conventional cancer care was complemented by acupuncture and related therapies there was an improvement in QoL, with reduced pain and fatigue [ 21 ]. In another review [ 22 ] a preliminary conclusion was that PC effectively relieves pain in patients with cancer. However, this review covered only a small number of studies ( n = 18) with several methodological limitations and exhibited a high heterogeneity of both pharmacological and non-pharmacological treatments.…”

Socioeconomic and racial/ethnic disparities in receipt of palliative care among patients with metastatic hepatocellular carcinoma

“…Palliative care (PC) has been shown to improve patients' QOL through mitigation of disease‐, treatment‐, and psychosocial‐related symptoms 7–12 . Some studies have even suggested a survival benefit to receiving PC for certain cancers 13 .…”

“…Palliative care (PC) has been shown to improve patients' QOL through mitigation of disease-, treatment-, and psychosocial-related symptoms. [7][8][9][10][11][12] Some studies have even suggested a survival benefit to receiving PC for certain cancers. 13 For stage IV HCC, a survival benefit has been shown with the receipt of palliative radiotherapy.…”