What is an “early palliative care” intervention? A scoping review of controlled studies in oncology

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2023-10-30 DOI:10.1002/cam4.6490

Stephan Nadolny, Eva Schildmann, Elena S. Gaßmann, Jan Schildmann

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Abstract

Introduction

Early palliative care (EPC) has been advocated to improve cancer patients' health. However, EPC differs with regard to its elements and target groups. It is not known which parts of EPC contribute to effectiveness for which patient group. This scoping review provides a structured analysis of EPC interventions and outcome measures.

Design

We searched EMBASE, MEDLINE, CINAHL, and CENTRAL up to February 2022. We included randomized controlled trials (RCT), nonrandomized trials, cohort studies (CS), and controlled before-after studies of EPC in adult patients in English, Dutch, and German language. Interventions had to be self-labeled as EPC. Screening and data extraction were performed by two raters. A structured analysis incorporating the TIDieR checklist was performed to describe the elements of the interventions.

Results

We screened 2651 articles, resulting in 40 articles being included: 34 studies were RCT and six studies were CS with a mean sample size of 208 patients. Patients with pancreatic (n = 10) and lung cancer (n = 9) were most often included. Studies reported different reference points for the onset of EPC such as time after diagnosis of incurable cancer (n = 18) or prognosis (n = 9). Thirteen studies provided information about elements of EPC and eight studies about the control intervention. Most frequent elements of EPC were symptom management (n = 28), case management (n = 16), and advance care planning (ACP; n = 15). Most frequently reported outcome measures were health-related quality of life (n = 26), symptom intensity (n = 6), resource use, and the patient's mood (n = 4 each).

Conclusion

The elicited heterogeneity of ECP in combination with deficits of reporting are considerable barriers that should be addressed to further develop effective EPC interventions for different groups of cancer patients.

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什么是“早期姑息治疗”干预？肿瘤学对照研究的范围综述。

简介：早期姑息治疗（EPC）已被提倡改善癌症患者的健康。然而，EPC在其要素和目标群体方面有所不同。目前尚不清楚EPC的哪些部分对哪个患者群体的有效性有贡献。该范围界定审查提供了EPC干预措施和成果措施的结构化分析。设计：截至2022年2月，我们搜索了EMBASE、MEDLINE、CINAHL和CENTRAL。我们纳入了随机对照试验（RCT）、非随机试验、队列研究（CS）和成年患者EPC前后对照研究（英语、荷兰语和德语）。干预措施必须自我标记为EPC。筛选和数据提取由两名评分员进行。结合TIDieR检查表进行了结构化分析，以描述干预措施的要素。结果：我们筛选了2651篇文章，共纳入40篇文章：34项研究为随机对照试验，6项研究为CS，平均样本量为208名患者。胰腺癌患者（n = 10）和癌症（n = 9）最常被包括在内。研究报告了EPC发病的不同参考点，如诊断为不可治愈的癌症后的时间（n = 18）或预后（n = 9）。13项研究提供了有关EPC要素的信息，8项研究则提供了有关控制干预的信息。EPC最常见的因素是症状管理（n = 28），病例管理（n = 16）和预先护理计划（ACP；n = 15）。最常报告的结果指标是与健康相关的生活质量（n = 26），症状强度（n = 6）、资源使用和患者情绪（n = 结论：ECP的异质性与报告缺陷相结合是相当大的障碍，应加以解决，以进一步开发针对不同癌症患者群体的有效EPC干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.