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. 2014 Dec;12(12):1763-71; quiz 1771.
doi: 10.6004/jnccn.2014.0177.

The integration of early palliative care with oncology care: the time has come for a new tradition

Jessica R Bauman  1 , Jennifer S Temel  1
Affiliations

The integration of early palliative care with oncology care: the time has come for a new tradition

Jessica R Bauman et al. J Natl Compr Canc Netw. 2014 Dec.

Abstract

The past decade has brought forth innovative research that questions the traditional oncology care model for patients with advanced cancer. Through integrating palliative care (PC) early into the disease course for patients with a poor-prognosis cancer, 3 seminal studies showed improvements in outcomes, ranging from quality of life, mood, patient satisfaction, prognostic understanding, health service use, and possibly survival. The results of these paradigm-changing studies generate questions about the mechanisms through which early PC improves patient outcomes and about how best to disseminate early PC models. This article reviews the 3 studies, examines challenges to conducting PC research, and considers future directions in the field.

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Figures

Figure 1
Figure 1
The trial designs: (A) Project ENABLE II, (B) early palliative care in NSCLC, and (C) early palliative care in advanced cancers. Abbreviations: CARES-MIS, Cancer Rehabilitation Evaluation System Medical in Interaction Subscale; CES-D, Center for Epidemiological Studies Depression Scale; ED, emergency department; ENABLE, Educate, Nurture, Advise, Before Life Ends; EOL, end of life; ESAS, Edmonton Symptom Assessment Scale; FACT-L, Functional Assessment of Cancer Therapy-Lung; FACIT-PC, Functional Assessment of Chronic Illness Therapy-Palliative Care; FACITSp, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being; FAMCARE-P16, FAMCARE Patient Satisfaction with Care 16-item measure; GI, gastrointestinal; GU, genitourinary; GYN, gynecologic; HADS, Hospital Anxiety and Depression Scale; ICU, intensive care unit; NH, New Hampshire; NSCLC, non–small cell lung cancer; PC, palliative care; PHQ-9, Patient Health Questionnaire 9; QOL, quality of life; VT, Vermont.
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