A study evaluating the impact of palliative care on patients with serious diseases, such as cystic fibrosis (CF), and their caregivers, found it to improve patients’ quality of life and disease symptoms, and brought a sense of satisfaction to both patients and their caregivers. Palliative care, however, did not improve survival.
Findings from the study, “Association Between Palliative Care and Patient and Caregiver Outcomes – A Systematic Review and Meta-analysis,’’ were published in the Journal of the American Medical Association (JAMA).
Palliative care is a multidisciplinary approach provided by healthcare professionals, such as physicians, physiotherapists, and nurses, to help patients with serious diseases relieve their suffering by improving their physical symptoms, pain, and psychological distress.
Although palliative care is in some countries, including the United States, a board certified sub-speciality of internal medicine and has attracted attention in recent years as a means of improving care, its overall outcomes and efficacy are still not fully clear.
“As a field, we need to develop new methods of studying how palliative care impacts people with serious illness and their caregivers,” Dio Kavalieratos, PhD, assistant professor of medicine in the Section of Palliative Care and Medical Ethics at the University of Pittsburgh School of Medicine, and the study’s lead author, said in a news release. “These methods should not burden patients and caregivers who participate in this research, but also need to be rigorous enough to capture what’s going on at this critical point in people’s lives.”
Palliative care has, historically, been associated with end-of-life care and “overwhelmingly” focused on people with terminal illnesses like cancer, Kavalieratos said. “[B]ut anyone with a serious illness, be it cancer, heart failure, multiple sclerosis or cystic fibrosis, deserves high-quality, individualized care that focuses on reducing their suffering and improving their quality of life,” he said. “We need to find ways of integrating palliative care concepts in patients’ usual care experiences so it isn’t a luxury, but a standard part of health care for those living with serious illness.”
Researchers performed a meta-analysis of randomized clinical trials to assess the benefit of palliative care on patients and their caregivers, in terms of improvements in quality of life, disease symptoms, survival, and mood, among others.
The team surveyed several data bases, including MEDLINE, EMBASE, CINAHL, and Cochrane CENTRAL, up to July 2016, and identified 43 trials of palliative care interventions that included 12,731 patients with serious diseases and 2,479 caregivers.
Results suggested that palliative care statistically and clinically improved the patients’ quality of life and disease symptoms at one- to three-month follow-ups. But no improvement was seen in patients’ survival rate.
“Taken all together, this is a very compelling message,” said Kavalieratos. “People’s quality of life and symptoms improved; their satisfaction with their health care improved — all during what is likely one of the most difficult periods of their lives.”
Palliative care was also found to positively impact other parameters, such as advance care planning, the satisfaction of both patients and their caregivers, and to reduce healthcare utilization. The association between palliative care and parameters like patients’ mood, healthcare expenditures, and caregiver quality of life require, however, were unclear and in need of further investigation, the research team reported.