gms | German Medical Science

Background/research question: Initiating palliative care, early in the disease process is nowadays highly advocated in oncology. However, there is considerable controversy about the timing and nature of these palliative care interventions [1]. In addition, palliative care has been widely established as standard care in oncology. We want to analyze the variables of the interventions on so called ‘early palliative care’ interventions for adult patients in clinical oncology care to illicit congruent as well as conflicting elements embedded in scientific studies that aim to evaluate the effectiveness of palliative care.

Methods: We conducted a systematic review searching Medline, Cinahl and Central up to May 2020. We included studies on early palliative care for adult patients in the clinical oncology setting which labelled themselves as ‘early palliative care’. Included study designs were (non-) randomized-controlled trials (RCTs), cohort studies, controlled before-after studies and interrupted time series. We analyzed the interventions according to the domains of the Template of Intervention Description and Replication (TIDieR). We did not perform a standardized risk of bias assessment. Prospero ID: 2344324.

Results: We identified 3,315 articles. After removing duplicates, we screened 2,222 articles and included 20 RCTs and one cohort study in the analysis. Most studies covered the USA (n=10) and focused on multiple forms of cancer (n=15) rather than one specific type (n=6). There is considerable heterogeneity in the different domains of TIDIER with the timing spanning from the onset of therapy to the onset of end-of-life care. The content of the interventions covers communication, symptom management, psychosocial care, prevention approaches, advance care planning and case management elements. Further details of the ongoing analysis are going to be presented at the conference.

Conclusion: Given the differing needs of patients with cancer and the specific skills needed for the different services offered under the label of ‘early palliative care’, it seems important to clarify the goal and nature of early palliative care. It is important to clearly distinguish between services provided by specialist palliative care professionals compared to basic palliative care skills which can be provided in standard oncology [2].

Competing interests: The authors declare that they have no known conflicts of interest