Palliative versus hospice care in patients with cancer: a systematic review

Abstract

BackgroundGuidelines recommend an early access to specialised palliative medicine services for patients with cancer, but studies have reported a continued underuse. Palliative care facilities deliver early care, alongside antineoplastic treatments, whereas hospice care structures intervene lately, when cancer-modifying treatments stop.AimThis review identified factors associated with early and late interventions of specialised services, by considering the type of structures studied (palliative vs hospice care).DesignWe performed a systematic review, prospectively registered on PROSPERO (ID: CRD42018110063).Data sourcesWe searched Medline and Scopus databases for population-based studies. Two independent reviewers extracted the data and assessed the study quality using Joanna Briggs Institute critical appraisal checklists.ResultsThe 51 included articles performed 67 analyses. Most were based on retrospective cohorts and US populations. The median quality scores were 19/22 for cohorts and 15/16 for cross-sectional studies. Most analyses focused on hospice care (n=37). Older patients, men, people with haematological cancer or treated in small centres had less specialised interventions. Palliative and hospice facilities addressed different populations. Older patients received less palliative care but more hospice care. Patients with high-stage tumours had more palliative care while women and patients with a low comorbidity burden received more hospice care.ConclusionMain disparities concerned older patients, men and people with haematological cancer. We highlighted the challenges of early interventions for older patients and of late deliveries for men and highly comorbid patients. Additional data on non-American populations, outpatients and factors related to quality of life and socioeconomic status are needed.

Palliative Care Costs in Different Ambulatory-Based Settings: A Systematic Review

“…Hospice services: community-based care that is offered, ideally, by a multidisciplinary team that supports patients with advanced disease and their families, [ 28 ] and can be provided in a patient’s home setting or in palliative and hospice facilities. Hospice care may be provided to outpatients or inpatients [ 29 ].…”

Exploration and practice of humanistic education for medical students based on volunteerism

“…With the growth of health care, hospice care has become a popular area of humanistic medical care. Hospice care is a type of medical care that focuses on alleviating the symptoms of a patient’s illness and slowing its progression in the weeks or even months before their death [ 43 ]. Research has shown that medical students can develop personal reflection and empathy skills as hospice volunteers [ 44 ].…”

Palliative care delivery according to age in 12,000 women with metastatic breast cancer: Analysis in the multicentre ESME-MBC cohort 2008–2016

“…Governmental programs have regularly supported the development of inpatient palliative care (IPC) (8,9). However, data regarding the efficiency of IPC delivery among cancer patients in Europe are limited (10).…”

“…However, an increasing number of studies have reported a low number of referrals for palliative care in older cancer patients (13,14). The majority of studies have analysed global cancer populations (10) and failed to compare patients with similar cancer-related needs. The comparison of IPC delivery in young and older patients with similar cancers is essential for MBC patients due to the variable prognosis of the different tumoural subtypes.…”

“…Most studies on palliative care delivery have analysed deceased populations, which entails a high risk of selection bias (10,15). The MBC cohort of the UNICANCER ESME (Epidemio-Strategy-Medical-Economical) programme includes MBC patients primarily treated within the national network of comprehensive cancer centres.…”