A randomized trial of a palliative care intervention for patients on phase I studies
| Autor: | Rhonda S. Cooper, Betty Ferrell, Nilofer S. Azad, Vincent Chung, Mark T. Hughes, Thomas J. Smith, Marianna Koczywas, Nora Ruel, Louise Knight |
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| Rok vydání: | 2020 |
| Předmět: |
Cancer Research
medicine.medical_specialty Palliative care business.industry Phase (combat) Therapeutic trial law.invention 03 medical and health sciences 0302 clinical medicine Oncology Randomized controlled trial law 030220 oncology & carcinogenesis Intervention (counseling) Physical therapy medicine business 030215 immunology |
| Zdroj: | Journal of Clinical Oncology. 38:12001-12001 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | 12001 Background: The purpose of this study was to test a Palliative Care Intervention for patients with solid tumors enrolled in phase I therapeutic trials. Methods: This randomized trial compared patients accrued to phase I Clinical Trials in groups of Usual Care compared to a Palliative Care Intervention (PCI) in two comprehensive cancer centers. The PCI included assessment of quality of life (QOL) and symptoms, an interdisciplinary meeting to discuss the care plan, including goals of care, and two nurse-delivered teaching sessions. Subjects (n=479) were followed for 24 weeks, with 12 weeks as the primary outcome point. Results: Outcomes revealed that relative to Usual Care, PCI subjects showed less Psychological Distress (1.9 in Intervention and 1.2 in Control pts, p=0.03) and a trend toward improved QOL (3.7 versus 1.6, p=0.07), with differences between sites. We observed high rates of symptom-management admissions (41.3%) and low rates of Advance Directive completion (39%), and use of supportive care services including hospice (30.7%, for only1.2 months duration), despite a median survival for all patients in both groups of 10.1 months from initiating a phase 1 study until death. Patient satisfaction with oncology care was already high at baseline, and we did not see clinically significant changes in those scores by week 12. Conclusions: Palliative care interventions can improve QOL outcomes and distress for patients participating in phase 1 trials. Greater integration of PC is needed to provide quality care to these patients and to support transitions from treatment to supportive care, especially at the end of life. Clinical trial information: NCT01828775 . |
| Databáze: | OpenAIRE |
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