The effect of community-based palliative supportive care integrated with primary health care (PHC) on the outcomes of terminally ill cancer patients.

Background: Cancer is increasing worldwide. Palliative care can help reduce the suffering of patients with cancer. Providing palliative care with a primary health care (PHC) approach can lead to greater patient access to palliative services. Given the lack of studies in this area, the present study aimed to determine the impact of community-based palliative care integrated with PHC on outcomes of terminally ill cancer patients.

Methods: This was a randomized controlled trial. Research population included 120 cancer patients in Khorramabad in 2023. A convenience sampling method was conducted, and then subjects were allocated to the intervention and control groups through randomization blocks with size of four. Subjects in the intervention group received PHC-integrated community-based palliative support for two months, while their control peers received their routine health care programs during the same period. The data were gathered using the Palliative Care Outcome Scale before and two months after the intervention and then were analyzed using SPSS 22 software and descriptive and inferential statistics.

Results: The mean scores of all dimensions of palliative outcomes, including physical, psychological, emotional, and social, as well as the overall palliative care outcome, improved after the intervention in the experimental group, and these changes were statistically significant (p < 0.001). Before the intervention, the mean score of overall palliative care outcome was 22.21 ± 2.89 in the intervention group and 21.88 ± 2.55 in the control group (P = 0.51), While after the intervention, the mean scores in the experimental and control groups changed to 17.98 ± 2.88 and 21.83 ± 2.69, respectively, and this difference was statistically significant (p < 0.001). The mean changes in the overall palliative outcome score before and after the intervention in the experimental and control groups were 4.23 ± 2.83 and 0.5 ± 0.72, respectively, and this difference was statistically significant (p < 0.001).

Conclusion: The community-based palliative care integrated into the PHC structure could positively affect all aspects of palliative care. It is recommended that policymakers create conditions where cancer patients can receive care through the PHC structure. More studies are required to designate the strengths and weaknesses of this care approach.

Trial registration number: IRCT20180721040540N5, 2023-06-07, Registered on June 7,2023. https://irct.behdasht.gov.ir/user/trial/68288/view .