Palliative Care Intervention Beneficial in Advanced Cancer

Nurse-led intervention increases quality of life, but has limited effect on symptom intensity
By Andrea Mongler
HealthDay Reporter

TUESDAY, Aug. 18 (HealthDay News) -- The combination of a nurse-led palliative care intervention and oncology care results in improved quality of life and mood for advanced cancer patients, according to a study published in the Aug. 19 Journal of the American Medical Association.

Marie Bakitas, A.P.R.N., of Dartmouth Hitchcock Medical Center in Lebanon, N.H., and colleagues studied 322 patients with advanced cancer of the gastrointestinal tract, lung, genitourinary tract or breast, half of whom were randomized to usual care and half of whom were randomized to a nursing-led intervention. This multicomponent, psycho-educational intervention (Project Educate, Nurture, Advise, Before Life Ends, or ENABLE) was conducted by advanced practice nurses and consisted of four weekly sessions and monthly follow-up sessions.

The researchers found that the estimated mean treatment effects (intervention minus usual care) for all participants were −27.8 for symptom intensity, −1.8 for depressed mood, and 4.6 for quality of life. For patients who died during the study, the estimated mean treatment effects were −24.2 for symptom intensity, −2.7 for depressed mood, and 8.6 for quality of life.

"This study shows that integration of a nurse-led, palliative care intervention concurrent with anticancer treatments demonstrated higher quality of life, lower depressed mood, but limited effect on symptom intensity scores and use of resources in intervention participants relative to those receiving usual cancer care. The intervention had no effect on the number of days in the hospital and intensive care unit, the number of emergency department visits, or anticancer treatment," the authors write.

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