Patients receiving palliative care report improved quality of life and symptom burden and higher satisfaction with their healthcare, a data meta-analysis shows. For caregivers, the evidence of improvement is mixed.
People coping with serious illness who are under palliative care have a better quality of life and suffer fewer symptoms than those who don't receive palliative care, a new study from the University of Pittsburgh School of Medicine shows.
The study, which appears this week in the Journal of the American Medical Association, is the first meta-analysis of palliative care's effect on patients' quality of life, symptoms and survival.
The researchers reviewed 43 trials of palliative care interventions, including 12,731 adults with serious illness and 2,479 of their family caregivers. Researchers also performed a meta-analysis on the association between palliative care and three outcomes linked with palliative care—patients' quality of life, symptom burden, and survival.
"Taken all together, this is a very compelling message," said study lead author Dio Kavalieratos, assistant professor of medicine in the Section of Palliative Care and Medical Ethics in Pitt's Division of General Internal Medicine.
"People's quality of life and symptoms improved; their satisfaction with their healthcare improved—all during what is likely one of the most difficult periods of their lives."
Kavalieratos' team found that palliative care was associated with improvements in advance care planning, patient and caregiver satisfaction with care, and lower healthcare utilization. There was mixed evidence of improvement, however, with site of death, patient mood, healthcare expenditures, and caregiver quality of life, mood or burden.
Beyond Cancer
"Historically, palliative care has overwhelmingly focused on individuals with cancer, but 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," Kavalieratos 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 healthcare for those living with serious illness."
Over the past five years, much attention has been paid to the idea that palliative care improves patients' survival, Kavalieratos added. Although some individual studies had shown that, the association didn't play out when multiple studies were pooled together in the meta-analysis.
"As a field, we need to develop new methods of studying how palliative care impacts people with serious illness and their caregivers," Kavalieratos added.
"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."