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Palliative Care Effective in Boosting Patient Quality of Life

Two JAMA studies highlight palliative care as efficacious in improving patient quality of life for a variety of severe illnesses.

Palliative care has shown itself effective in improving quality of life for patients with a variety of serious illnesses in two studies recently published in the Journal of the American Medical Association.

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Palliative care providers usually supplement treatment for patients with serious, sometimes terminal, illnesses. This care typically focuses on offering comfort to patients by reducing physical symptoms, catering to psychological and emotional needs, and offering advanced care planning.

A study conducted by Areej El-Jawahri, MD, Thomas LeBlanc, MD, and Harry VanDusen, BS determined that palliative care is helpful in improving quality of life for patients suffering from blood disorders and receiving a stem cell transplant as a part of their treatment.

This patient population often faces diminished quality of life throughout their three- or four-week treatment because they undergo chemotherapy prior to the transplant. The effects of this treatment cause considerable physical discomfort, the researchers said, alongside physical isolation and emotional woes.

To test its effects, the researchers administered palliative care to 81 stem cell transplant patients and delivered normal care to 79 patients. Those in the control group could receive palliative care upon request. However, only two patients chose this option, showing how infrequently palliative care is administered and the importance of understanding its effects, the researchers said.

The researchers assessed quality of life by administering a score based on patient anxiety and depression levels, symptoms, and post-traumatic stress disorder symptoms.

After two weeks of treatment, those in the palliative care group had higher quality of life scores than those in the control group.

“Exploratory secondary outcomes also showed that patients in the palliative care group benefited, with less increase in their depression symptoms, lower anxiety symptoms, and less increase in symptom burden compared with those receiving standard transplant care,” the researchers reported.

“Thus, palliative care may help to lessen the decline in QOL experienced by patients during hospitalization for HCT, which has long been perceived as a natural aspect of the transplantation process.”

The study also showed that administering palliative care can have a positive effect on providers. When providers care for extremely sick patients with low quality of life, it can be emotionally taxing, the researchers explained.

“The palliative care intervention led to improvements in caregivers’ coping and depression symptoms at 2 weeks but no significant improvement in caregivers’ QOL or anxiety symptoms,” the research team said. “These findings suggest that modifying patients’ experience during HCT may have some positive effects on some aspects of caregivers’ well-being.”

Another study, also published in the most recent issue of JAMA, supports these findings. Researchers from the University of Pittsburgh School of Medicine looked at 43 palliative care trials and found that this kind of patient-centered care improves both patient quality of life and satisfaction with care, according to a university press release.

Palliative care was also associated with caregiver satisfaction, lower care utilization, and better advanced care planning. Improved advanced care planning is an important aspect of patient-centered care, the researchers acknowledged, because it helps providers identify and fulfill patient needs at the end of life.

According to lead researcher Dio Kavalieratos, PhD, assistant professor of medicine at Pitt, the study’s results shows that palliative care can be useful for all patients suffering from a serious illness.

“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.

“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.”

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