In a study appearing in the November 22/29 issue of JAMA, researchers examined the association of palliative care with quality of life, symptom burden, survival, and other outcomes for people with life-limiting illness and for their caregivers.
Palliative care focuses on improving quality of life (QOL) and reducing suffering for seriously ill patients and their families. More than 65% of US hospitals have an inpatient palliative care program. To provide an up-to-date summary of palliative care outcomes, the authors identified 43 randomized clinical trials of palliative care interventions in adults with life-limiting illness for a systematic review and meta-analyses. The trials provided data on 12,731 patients (average age, 67 years) and 2,479 caregivers. Thirty-five trials used usual care as the control, and 14 took place in the ambulatory setting.
In the meta-analysis, palliative care was associated with statistically and clinically significant improvements in measures of patient QOL and symptom burden at the 1- to 3-month follow-up. When analyses were limited to trials at low risk of bias (n = 5), the association between palliative care and QOL was lessened but remained statistically significant, whereas the association with symptom burden was not statistically significant. There was no association between palliative care and survival. Findings for caregiver outcomes were inconsistent.
Palliative care was associated consistently with improvements in advance care planning, patient and caregiver satisfaction, and lower health care utilization. There was mixed evidence of associations of palliative care with site of death; patient mood; health care expenditures; and caregiver QOL, mood, or burden.
Read the full study in JAMA.
