Palliative care in patients with haematological neoplasms: An integrative systematic review

Moreno-Alonso, Deborah; Porta-Sales, Josep; Monforte-Royo, Cristina; Trelis-Navarro, Jordi; Sureda-Balarí, Anna; Sevilla-Ribosa, Alberto Fernández De

doi:10.1177/0269216317735246

Cited by 54 publications

(56 citation statements)

References 124 publications

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“…Various studies indicate that the mean number of physical symptoms, symptom burden, and level of distress in HM patients are at least as high as in patients with advanced solid tumors [2,3]. Their performance status often seems to be even worse [4].…”

Section: Problems and Needs Of Patients With Advanced Hematological Mmentioning

confidence: 99%

“…A review analysis even demonstrated that they also have a more than 50% reduced chance to receive specialist palliative or hospice care compared to solid cancers patients [10]. In patients in whom palliative or hospice care is initiated, they are often limited to the end-of-life phase with late referral to palliative care [3]. Patients with HM are more likely to die within 24 hours after hospice enrollment or within 7 days after hospice admission compared to solid tumor patients [4].…”

Section: End-of-life Care In Patients With Hematological Malignanciesmentioning

confidence: 99%

“…Physical and emotional symptom burden, improved, over time [22]. In addition, various studies describe a high general satisfaction with SPC in patients and their families [3]. …”

Section: Experiences With Palliative Carementioning

confidence: 99%

“…Tools to adequately predict survival in this population of patients with heterogeneous prognosis are lacking [3]. In a first approach, a multivariate model identified clinical prognosis and patient's self-reported severity of drowsiness parameters as independent prognostic factors for survival in patients with advanced HM [37].…”

Section: Potential Indications For Palliative Care Needmentioning

confidence: 99%

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Palliative Care in Patients with Hematological Malignancies

Oechsle¹

2018

Oncol Res Treat

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Patients with hematologic malignancies (HM) nowadays rarely receive palliative or hospice care, and studies on potential effects of integrated palliative care are rare. This narrative review provides a comprehensive overview on their current end-of-life care, first data on integrated specialist palliative care (SPC) and potential barriers. Symptom burden and distress in patients with HM seem to be comparable to other cancer patients, but their performance status and specific symptoms are even worse. Prolongation of life usually remains the main focus until the last days or weeks of life. Their chance to die in hospital is twice as high, but their chance to receive specialist palliative or hospice care is only half of that of other cancer patients. Prospective studies indicate a high acceptability and positive effects of integrated SPC, e.g. clarification of treatment goals, stabilization of quality of life, decreased depression, anxiety, symptom burden, and post-traumatic stress disorders. Interdisciplinary cooperation, timely discussions about SPC referral, and indicators to ‘flag' patients in need for SPC are important, but they are largely missing. In conclusion, further studies have to evaluate factors identifying patients with HM in need for SPC. Further models of early integrated palliative care should be evaluated in prospective studies and established in daily clinical practice.

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Section: Problems and Needs Of Patients With Advanced Hematological Mmentioning

confidence: 99%

Section: End-of-life Care In Patients With Hematological Malignanciesmentioning

confidence: 99%

“…Physical and emotional symptom burden, improved, over time [22]. In addition, various studies describe a high general satisfaction with SPC in patients and their families [3]. …”

Section: Experiences With Palliative Carementioning

confidence: 99%

Section: Potential Indications For Palliative Care Needmentioning

confidence: 99%

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Palliative Care in Patients with Hematological Malignancies

Oechsle¹

2018

Oncol Res Treat

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“…A significant body of international literature highlights there are challenges providing palliative and end-of-life care in the specialty area of clinical malignant haematology (Moreno-Alonso et al, 2017). People with a haematological malignancy often experience a fluctuating and unpredictable illness trajectory and can deteriorate rapidly to a terminal event (Hung et al, 2013;Manitta, Philip, & Cole-Sinclair, 2010;McGrath & Holewa, 2007).…”

Section: Introductionmentioning

confidence: 99%

Harnessing the power of clinician judgement. Identifying risk of deteriorating and dying in people with a haematological malignancy: A Delphi study

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Gavin

Chan

et al. 2018

Journal of Advanced Nursing

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Aim To provide expert consensus on the clinical indicators that signal a person with a haematological malignancy is at high risk of deteriorating and dying. Background Identification of people who are at risk of deteriorating and dying is essential to facilitate patient autonomy, appropriate treatment decisions, and effective end‐of‐life care. Design A three‐step modified Delphi approach. Methods The study was conducted over 6 months (September 2015–March 2016) to gather opinion from an international panel of experts (N = 27) on the clinical indicators that signal a person with a haematological malignancy is at high risk of deteriorating and dying. The first round was informed by a systematic review of prognostic factors present in the final months of life for people with a haematological malignancy. Consensus was achieved if 70% of responses fell within two points on a seven‐point Likert‐type scale. Findings Consensus was achieved on the following 11 clinical indicators: (a) advancing age; (b) declining performances status; (c) presence of co‐morbidities; (d) disease status; (e) persistent infections (bacterial and viral); (f) fungal infections; (g) severe graft versus host disease; (h) requiring high care; (i) signs of frailty; (j) treatment limitations; and (k) anorexia and/or weight loss. Consensus was also achieved on associated themes and statements for each indicator. Conclusion The findings of this study indicate that subjective clinician‐assessed indicators that are contextually relevant to the nature of haematological malignancies are markers of risk. This study has provided valuable preliminary findings on the topic and will inform future research.

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Haematological nurses' experiences about palliative care trajectories of patients with life‐threatening haematological malignancies: A qualitative study

et al. 2022

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Aims To explore haematological nurses' experiences about the palliative care trajectories of patients with life‐threatening haematological malignancies. Design A qualitative study with a descriptive and explorative design. Methods Data were collected through 12 individual semi‐structured interviews of nurses who work with patients with haematological malignancies from four hospitals in Norway. The data were analysed using systematic text condensation. The study was reported according to the Consolidated Criteria for Reporting Qualitative Research checklist. Results Three categories emerged from the data analysis: focus on a cure delays integration of palliative care, dialogue with patients facilitates palliative care and the need for enhanced interdisciplinary understanding. Patient or public contribution No patient or public contribution since nurses' experiences were explored.

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Palliative care in patients with haematological neoplasms: An integrative systematic review

Cited by 54 publications

References 124 publications

Palliative Care in Patients with Hematological Malignancies

Palliative Care in Patients with Hematological Malignancies

Harnessing the power of clinician judgement. Identifying risk of deteriorating and dying in people with a haematological malignancy: A Delphi study

Haematological nurses' experiences about palliative care trajectories of patients with life‐threatening haematological malignancies: A qualitative study

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