Articles: palliative-care.
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British journal of cancer · Sep 2002
Randomized Controlled Trial Comparative Study Clinical TrialThe imPaCT study: a randomised controlled trial to evaluate a hospital palliative care team.
A randomised controlled trial was undertaken to assess the effectiveness of a hospital Palliative Care Team (PCT) on physical symptoms and health-related quality of life (HRQoL); patient, family carer and primary care professional reported satisfaction with care; and health service resource use. The full package of advice and support provided by a multidisciplinary specialist PCT ('full-PCT') was compared with limited telephone advice ('telephone-PCT', the control group) in the setting of a teaching hospital trust in the SW of England. The trial recruited 261 out of 684 new inpatient referrals; 175 were allocated to 'full-PCT', 86 to 'telephone-PCT' (2 : 1 randomisation); with 191 (73%) being assessed at 1 week. ⋯ A smaller effect was seen in 'telephone-PCT'; there were no significant differences between the groups. Satisfaction with care in both groups was high and there was no significant difference between them. These data reflect a high standard of care of patients dying of cancer and other chronic diseases in an acute hospital environment, but do not demonstrate a difference between the two models of service delivery of specialist palliative care.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Immediate versus delayed palliative thoracic radiotherapy in patients with unresectable locally advanced non-small cell lung cancer and minimal thoracic symptoms: randomised controlled trial.
To determine whether patients with locally advanced non-small cell lung cancer unsuitable for resection or radical radiotherapy, and with minimal thoracic symptoms, should be given palliative thoracic radiotherapy immediately or as needed to treat symptoms. ⋯ In minimally symptomatic patients with locally advanced non-small cell lung cancer, no persuasive evidence was found to indicate that giving immediate palliative thoracic radiotherapy improves symptom control, quality of life, or survival when compared with delaying until symptoms require treatment.
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Randomized Controlled Trial Comparative Study Clinical Trial
Patterns, costs and cost-effectiveness of care in a trial of chemotherapy for advanced non-small cell lung cancer.
In a recently published randomised trial of chemotherapy versus palliative care in advanced non-small cell lung cancer (the MIC2 trial), chemotherapy was shown to prolong survival without compromising quality of life. The study presented here examines patterns of care and their associated costs within a representative subgroup of patients from the MIC2 trial. The study consisted of 116 patients from the South Birmingham Health Authority area. ⋯ Non-parametric bootstrapping gave a difference between treatment arms in mean cost of 2924 pounds sterling(95% CI 1234 pounds sterling - 4323 pounds sterling). With a difference in mean survival of 2.4 months, this translates to an incremental cost-effectiveness ratio of 14,620 pounds sterling per life year gained. Chemotherapy was found to be more costly than standard palliative care, mainly due to the increased number of hospital in-patient days.
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J Pain Symptom Manage · Jul 2002
Randomized Controlled Trial Clinical TrialFamily satisfaction with end-of-life care for cancer patients in a cluster randomized trial.
The main aim of this study was to examine similarities and differences in satisfaction with care between 112 family members who were close to patients who had participated in an intervention with a comprehensive palliative care program and the 68 family members in a conventional care program (controls). The FAMCARE Scale measured satisfaction with care at one month after the time of death. ⋯ The respondents related to the patients in the intervention group reported significantly higher satisfaction with care than the respondents related to the patients in the control group. This difference remained unchanged after controlling for a range of other relevant factors: relationship to the deceased, sex and age of the respondent, sex and age of the patient, time since inclusion in the study, and place of death.
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Palliative medicine · May 2002
Randomized Controlled Trial Clinical TrialPatient-held records in cancer and palliative care: a randomized, prospective trialt.
To evaluate prospectively the introduction of a patient-held record (PHR) in the management of patients with advanced cancer and palliative care needs. ⋯ This study provides no evidence on which to base the widespread promotion of PHRs, although local projects with committed clinicians and patients may well prove popular and effective.