| Popis: |
Background: Hematological malignancies (HMs) encompass a broad range of diagnoses with highly variable clinical courses, symptom burdens, and care needs. While palliative care (PC) intervention is well established in solid-organ malignancies (1), it is still to be determined how palliative care can best be applied to patients with HMs, especially in the rapidly changing landscape of therapeutic options for this population (2). Objective: This study will perform a systematic review of the literature as to the impact of PC on patients with HMs (lymphoma, plasma cell disorders, leukemia, myelodysplastic syndromes, and myeloproliferative neoplasms) in terms of patient and caregiver reported outcomes, healthcare utilization and economics at the end-of-life, and overall survival. This study will also examine barriers to implementation of purported PC interventions. Methods/Design: A systematic review from database inception to present will be conducted of Medline, Embase, CINAHL, PsycINFO, CENTRAL, and ClinicalTrials.gov, with further identification of citations via reference lists and Web of Science, using terms to represent PC intervention and HMs (appendix 1). Two independent reviewers will screen abstracts for eligibility based on age (>18 years), English publication, and application of a specified PC intervention with original data (either quantitative or qualitative) collected as to the impact on patient outcomes. Results/Conclusions: Results will be summarized qualitatively (appendix 2), with the intention to perform quantitative analysis if the data allows. The impact of PC on patients with HM will be summarized across a range of outcomes including patient and caregiver reported outcomes, survival, health economics, and end-of-life health care utilization. Secondary outcomes will include the feasibility of the purported PC intervention, potential barriers to implementation, and whether differences in outcome exist based on timing of the intervention, type of hematologic malignancy, and type of intervention. |
