Improving quality of life of patients with advanced cancer and their family carers. A randomized controlled trial to evaluate the effect of early and systematic integration of palliative care in oncology.
Abstract project
Background
The World Health Organization (WHO) defines palliative care (PC) as an approach to improve quality of life of patients and their family carers, facing a life-threatening illness, through prevention and relief of pain and of physical, psychosocial and spiritual problems. PC is traditionally offered late in the course of the incurable illness, e.g. when death is imminent. Studies in the US and Canada have shown that PC provided early in the disease trajectory has a meaningful effect on the quality of life and even on survival of patients with advanced cancer. So far, there is no evidence available from the effect of early PC in Europe.
Aim
The aim of this project is to evaluate the effect of early and systematic integration of PC in standard oncology care on (1) long term quality of life of patients with advanced cancer, (2) on end-of-life decisions and survival of patients and (3) on quality of life and mood of family caregivers in Flanders, Belgium.
Method
A randomized controlled trial was conducted, 186 patients with advanced cancer and 114 family carers were recruited from different oncology departments of Ghent University Hospital. Patients and family carers were randomized to early and systematic integration of palliative care in standard oncology care or standard oncology care alone. Patients and family carers filled out questionnaires regarding quality of life, mood and quality of care at baseline, at 12 weeks and 6-weekly thereafter. Other outcome measures are end-of-life care decisions and overall survival.
Discussion
This trial is the first randomized controlled trial in the Belgian health care setting to evaluate the effect of early and systematic integration of palliative care for advanced cancer patients. It is hypothesized that patients with advanced cancer who receive early and systematic integration of PC, in combination with standard oncology care will have a better long term health-related quality of life than patients who receive standard oncology care alone. Similarly, we expect improved quality of life for family carers who had early consultations with a member of the palliative care team.
