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Randomized Controlled Trial
. 2018 Jan;21(1):28-36.
doi: 10.1089/jpm.2017.0113. Epub 2017 Aug 3.

A Pilot Trial of Early Specialty Palliative Care for Patients with Advanced Pancreatic Cancer: Challenges Encountered and Lessons Learned

Yael Schenker  1 , Nathan Bahary  2   3 , Rene Claxton  1 , Julie Childers  1 , Edward Chu  2 , Dio Kavalieratos  1 , Linda King  1 , Barry Lembersky  3 , Greer Tiver  1 , Robert M Arnold  1
Affiliations
Randomized Controlled Trial

A Pilot Trial of Early Specialty Palliative Care for Patients with Advanced Pancreatic Cancer: Challenges Encountered and Lessons Learned

Yael Schenker et al. J Palliat Med. 2018 Jan.

Abstract

Background: Patients with advanced pancreatic cancer suffer from high morbidity and mortality. Specialty palliative care may improve quality of life.

Objective: Assess the feasibility, acceptability, and perceived effectiveness of early specialty physician-led palliative care for patients with advanced pancreatic cancer and their caregivers.

Design: A mixed-methods pilot randomized controlled trial in which patient-caregiver pairs were randomized (2:1) to receive specialty palliative care, in addition to standard oncology care versus standard oncology care alone.

Setting/subjects: At a National Cancer Institute-designated comprehensive cancer center in Western Pennsylvania, 30 patients with advanced pancreatic adenocarcinoma and their caregivers (N = 30), oncologists (N = 4), and palliative care physicians (N = 3) participated.

Measurements: Feasibility (enrollment, three-month outcome-assessment, and intervention completion rates), acceptability, and perceived effectiveness (process interviews with patients, caregivers, and physicians).

Results: Consent:approach rate was 49%, randomized:consent rate 55%, and three-month outcome assessment rate 75%. Two patients and three caregivers withdrew early. The three-month mortality rate was 13%. Patients attended a mean of 1.3 (standard deviation 1.1) palliative care visits during the three-month period. Positive experiences with palliative care included receiving emotional support and symptom management. Negative experiences included inconvenience, long travel times, spending too much time at the cancer center, and no perceived palliative care needs. Physicians suggested embedding palliative care within oncology clinics, tailoring services to patient needs, and facilitating face-to-face communication between oncologists and palliative physicians.

Conclusions: A randomized trial of early palliative care for advanced pancreatic cancer did not achieve feasibility goals. Integrating palliative care within oncology clinics may increase acceptability and perceived effectiveness.

Keywords: palliative care; pancreatic cancer; pilot trial.

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Conflict of interest statement

No competing financial interests exist.

Figures

<b>FIG. 1.</b>
FIG. 1.
CONSORT diagram.
<b>FIG. 2.</b>
FIG. 2.
Participation of randomized patient-caregiver pairs.
See this image and copyright information in PMC

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References

    1. Kavalieratos D, Corbelli J, Zhang D, et al. : Association between palliative care and patient and caregiver outcomes: A systematic review and meta-analysis. JAMA 2016;316:2104–2114 - PMC - PubMed
    1. Temel JS, Greer JA, Muzikansky A, et al. : Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010;363:733–742 - PubMed
    1. Bakitas MA, Tosteson TD, Li Z, et al. : Early versus delayed initiation of concurrent palliative oncology care: Patient outcomes in the ENABLE III randomized controlled trial. J Clin Oncol 2015;33:1438–1445 - PMC - PubMed
    1. Dionne-Odom JN, Azuero A, Lyons KD, et al. : Benefits of early versus delayed palliative care to informal family caregivers of patients with advanced cancer: Outcomes from the ENABLE III randomized controlled trial. J Clin Oncol 2015;33:1446–1452 - PMC - PubMed
    1. Maltoni M, Scarpi E, Dall'Agata M, et al. : Systematic versus on-demand early palliative care: Results from a multicentre, randomised clinical trial. Eur J Cancer 2016;65:61–68 - PubMed

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