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J Clin Oncol. 2001 Sep 15;19(18):3884-94.

Quality of life in palliative cancer care: results from a cluster randomized trial.

Author information

  • 1Palliative Medicine Unit, Department of Oncology and Radiotherapy, University Hospital of Trondheim, Trondheim, Norway. mjordhoy@online.no

Abstract

PURPOSE:

To assess the impact of comprehensive palliative care on patients' quality of life. The intervention was based on cooperation between a palliative medicine unit and the community service and was compared with conventional care.

PATIENTS AND METHODS:

A cluster randomized trial was carried out, with community health care districts defined as the clusters. Patients from these districts who had malignant disease and survival expectancy between 2 to 9 months were entered onto the trial. The main quality-of-life end points were physical and emotional functioning, pain, and psychologic distress assessed monthly by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) questionnaire and Impact of Event scale (IES). In total, 235 intervention patients and 199 controls were included.

RESULTS:

During the initial 4 months of follow-up, the compliance was good (72%) and comparable among treatment groups. No significant differences on any of the quality-of-life scores were found. At later assessments and for scores that were made within 3 months before death, there was also no consistent tendency in favor of any treatment group on the main outcomes or other EORTC QLQ-C30 scales/items.

CONCLUSION:

A general program of palliative care may be important to ensure flexibility and to meet the needs of terminally ill patients. However, to achieve improvements on a group level of the various dimensions of quality of life, specific interventions directed toward specific symptoms or problems may have to be defined, evaluated, and included in the program.

PMID:
11559726
[PubMed - indexed for MEDLINE]
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