Study shows that families of patients with chronic critical illnesses saw little benefit from meetings led by palliative care specialists, and higher symptoms of post-traumatic stress disorder compared to families that met with standard ICU teams.
Palliative care is supposed to provide relief from the symptoms and stress of serious illness, so a study suggesting that it doesn't comes as a surprise.
Despite what researchers were expecting, data collected from four medical intensive care units over four years found no difference in reported in levels of anxiety and depression for the families of patients with chronic critical illness who received informational and emotional support meetings led by palliative care clinicians.
Researchers looked at data from 2010 to 2014 and assessed the responses of two groups on the Hospital Anxiety and Depression Scale.
One group had structured family meetings led by palliative care specialists including palliative care physicians, nurse practitioners, and social workers. The other who had routine family meetings with the standard ICU team. Both groups also received an information brochure.
During these palliative care-led meetings, the patient's prognosis, values, goals, and care preferences were discussed.
PTSD Symptoms Seen in Families
Three months after the intervention, however, there was no significant difference in reports of anxiety and depression among surrogate decision makers in the two groups, no significant effect on duration of mechanical ventilation and length of hospital stay, and no effect on survival rates.
Instead, the group in the meetings led by palliative care specialists reported higher symptoms of post-traumatic stress disorder compared to the group that met with standard ICU teams.
The results of this study do not support mandatory meetings with palliative care specialists, write the study's authors, nor do the results suggest that palliative care consultations are unnecessary.
Instead, the study authors suggest that palliative care specialists should focus on patients who need assistance with pain and symptom management and patients and families at who are at high risk for poor emotional outcomes.