Do specialist palliative care teams improve outcomes for cancer patients? A systematic literature review

Abstract

The objective of the study was to determine whether teams providing specialist palliative care improve the health outcomes of patients with advanced cancer and their families or carers when compared to conventional services. The study involved a systematic literature review of published research. The source of the data included studies identified from a systematic search of computerized databases (Medline, psychINFO, CINAHL and BIDS to the end of 1996), hand-searching specialist palliative care journals, and studying bibliographies and reference lists. The inclusion criteria for articles were that the study considered the use of specialist palliative care teams caring for patients with advanced cancer. Articles were assessed and data extracted and synthesized, with studies graded according to design. A variety of outcomes were considered by the authors. These addressed aspects of symptom control, patient and family or carer satisfaction, health care utilization and cost, place of death, psychosocial indices and quality of life. Overall, 18 relevant studies were identified, including five randomized controlled trials. Improved outcomes were seen in the amount of time spent at home by patients, satisfaction by both patients and their carers, symptom control, a reduction in the number of inpatient hospital days, a reduction in overall cost, and the patients' likelihood of dying where they wished to for those receiving specialist care from a multiprofessional palliative care team. It was concluded that all evaluations were of services considered to be leading the field, or were pioneering training and treatments. However, when compared to conventional care, there is evidence that specialist teams in palliative care improve satisfaction and identify and deal with more patient and family needs. Moreover, multiprofessional approaches to palliative care reduce the overall cost of care by reducing the amount of time patients spend in acute hospital settings.

Living With Advanced Illness: Longitudinal Study of Patient, Family, and Caregiver Needs

“…10,[23][24][25][26][27][28][29][30][31] Increased median longevity was observed among patients with small-cell lung cancer in early referral outpatient palliative care settings versus usual care. 32 Patients provided with inpatient palliative care consults were less likely to die in intensive care units and more likely to receive hospice referrals.…”

Patterns of care at end of life for people with primary intracranial tumors: lessons learned

“…Reports on the value of hospices, home care programs, specialized palliative care teams in hospitals and regional programs have shown proven benefits to patients and families. [2][3][4] Promoting quality of life and reducing the burden of care to the patient are pivotal to the philosophy of end of life care. 5 How much has this philosophy influenced the care received by patients with intracranial tumors?…”

Interdisciplinary palliative care teams : insights and experiences of chaplain interns and social work interns.

“…Hearn and Higginson (1998) found evidence that interdisciplinary teams improve satisfaction of patient and family needs as compared to conventional care.…”

“…Other systematic reviews determined interdisciplinary teams improved family satisfaction (Hearn & Higginson, 1998;Zimmerman, Riechelmann, Krzyzanowska, Rodin, & Tannock, 2008). In one study there was an advantage of multidisciplinary teams over unidisciplinary care teams (Finlay et al, 2001).…”