2022
DOI: 10.1002/cam4.4565
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Impact of early palliative care according to baseline symptom severity: Secondary analysis of a cluster‐randomized controlled trial in patients with advanced cancer

Abstract: Background Early palliative care (EPC) improves the quality of life but may not be feasible for all patients with advanced cancer. Symptom screening has been suggested to triage patients for EPC, but scant evidence exists for this practice. Methods We conducted a subgroup analysis of a cluster‐randomized controlled trial of EPC vs. standard oncology care according to patients' baseline symptom scores (high [>23] vs. low [≤23] Edmonton Symptom Assessment System Distress … Show more

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Cited by 31 publications
(20 citation statements)
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References 41 publications
(127 reference statements)
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“…Of note, patients did not need to have supportive care needs to qualify for a palliative care referral in these trials. However, a recent secondary analysis of the Zimmermann trial found that patients with higher symptom burden at baseline were more likely to derive a benefit from the palliative care intervention [ 29 ].…”
Section: How Is Timely Palliative Care Different From Early Palliativ...mentioning
confidence: 99%
See 1 more Smart Citation
“…Of note, patients did not need to have supportive care needs to qualify for a palliative care referral in these trials. However, a recent secondary analysis of the Zimmermann trial found that patients with higher symptom burden at baseline were more likely to derive a benefit from the palliative care intervention [ 29 ].…”
Section: How Is Timely Palliative Care Different From Early Palliativ...mentioning
confidence: 99%
“…Similar to the concept of targeted therapy, oncologists may only offer treatment for selected patients with “targetable mutations” instead of treating all patients. This approach provides a more rational use of resources, minimizes unnecessary exposure to those who may be less likely to benefit, and maximizes the impact on patients offered the intervention [ 29 ].…”
Section: How Is Timely Palliative Care Different From Early Palliativ...mentioning
confidence: 99%
“…Although the definition of “early PC” has not been established, many trials on early integration used the timeframe of two to three months for their investigations [ 17 , 19 , 21 , 32 , 33 , 34 , 35 ]. Nevertheless, a recent analysis found that patients with a higher symptom burden profited more from the PC interventions [ 36 ]. Due to a lack of resources, it becomes less possible to provide early access to SPC for all cancer patients with advanced disease [ 37 ].…”
Section: Discussionmentioning
confidence: 99%
“…The concept of “timely” PC focuses on referral based on needs [ 9 ] and the delivery of services at the optimal time and setting [ 38 ]. Recent models for timely and adequate PC suggest offering “targeted PC” only to patients with PC needs instead of treating all patients, providing a more rational use of resources [ 36 ]. According to these suggestions, we also evaluated more disease-specific referral points for our patients with SCLC.…”
Section: Discussionmentioning
confidence: 99%
“…Following this study in 2012, the American Society of Clinical Oncology (ASCO) recommended that palliative care be integrated into oncology services early in the disease course and concurrently with other lifeprolonging therapies [33]. Subsequently, multiple studies have confirmed the benefits of outpatient palliative care showing decreased depression [34] and improved quality of life [18,[34][35][36], symptom burden [35][36][37], satisfaction with care [37][38][39][40], communication about end-of-life care preferences [34], survival [35,36,41], and healthcare utilization [37,42].…”
Section: Benefitsmentioning
confidence: 99%