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@article{1674064, author = {Sláma, Ondřej and Pochop, Lukas and Šedo, Jiří and Švancara, Jan and Šedová, Petra and Svetlakova, Lucie and Demlová, Regina and Vyzula, Rostislav}, article_location = {NEW ROCHELLE}, article_number = {12}, doi = {http://dx.doi.org/10.1089/jpm.2019.0697}, keywords = {advanced cancer; early palliative care; hospital-specific palliative care issues; multidisciplinary care; specialist palliative care}, language = {eng}, issn = {1096-6218}, journal = {JOURNAL OF PALLIATIVE MEDICINE}, title = {Effects of Early and Systematic Integration of Specialist Palliative Care in Patients with Advanced Cancer: Randomized Controlled Trial PALINT}, url = {https://www.liebertpub.com/doi/10.1089/jpm.2019.0697}, volume = {23}, year = {2020} }
TY - JOUR ID - 1674064 AU - Sláma, Ondřej - Pochop, Lukas - Šedo, Jiří - Švancara, Jan - Šedová, Petra - Svetlakova, Lucie - Demlová, Regina - Vyzula, Rostislav PY - 2020 TI - Effects of Early and Systematic Integration of Specialist Palliative Care in Patients with Advanced Cancer: Randomized Controlled Trial PALINT JF - JOURNAL OF PALLIATIVE MEDICINE VL - 23 IS - 12 SP - 1586-1593 EP - 1586-1593 PB - MARY ANN LIEBERT, INC SN - 10966218 KW - advanced cancer KW - early palliative care KW - hospital-specific palliative care issues KW - multidisciplinary care KW - specialist palliative care UR - https://www.liebertpub.com/doi/10.1089/jpm.2019.0697 L2 - https://www.liebertpub.com/doi/10.1089/jpm.2019.0697 N2 - Background: A broad consensus on the optimal structure, intensity, and timing of early specialist palliative care (SPC) intervention is lacking. Objective: To evaluate the benefit of an early and systematic palliative intervention alongside standard oncology care compared with standard oncology care alone in patients with advanced solid tumors. Design: PALINT, a single-center RCT, conducted at the Masaryk Memorial Cancer Institute, the largest comprehensive cancer center in the Czech Republic (CR). Setting/Subjects/Measurements: Patients with newly diagnosed advanced cancer within six weeks from the start of the palliative systemic therapy were randomly assigned to the integration of SPC (intervention; a consultation with a PC physician every six to eight weeks) or to the standard oncology care (control). The primary endpoint was the quality of life (QOL) assessed by EORTC QLQ C30 and Hospital Anxiety and Depression Scale (HADS) at three and six months. Results: From 2015 to 2017, a total of 126 patients were randomly assigned to intervention (60) or to control (66) arm. At baseline, at three and six months, the global QOL scores (mean, 95% CI) in the intervention and control arm were 58.6 (53.9-63.3), 61.9 (56.4-67.4) and 66.7 (60.2-73.2) versus 54.2 (49.4-58.9), 59.0 (53.7-64.3), and 62.8 (56.7-68.9), respectively. The prevalence of anxiety (HADS-A; value >7) was 36.7%, 27.5%, and 18.9% versus 34.8%, 23.5%, and 16.3% and the prevalence of depression (HADS-D; value >7) was 28.3%, 25.4%, and 29.7% versus 28.8%, 29.4%, and 27.9%, respectively. There was no significant difference between the two arms. The overall survival was similar in both arms (347 vs. 310 days; p = 0.203). Conclusions: A model of early integration of SPC consisting of a consultation with a PC physician alone every six to eight weeks did not increase the QOL of patients with advanced cancer compared with routine oncology care in a center with widely available supportive services. These negative results underline the importance of the multidisciplinary patient centered approach in the early SPC. ER -
SLÁMA, Ondřej, Lukas POCHOP, Jiří ŠEDO, Jan ŠVANCARA, Petra ŠEDOVÁ, Lucie SVETLAKOVA, Regina DEMLOVÁ a Rostislav VYZULA. Effects of Early and Systematic Integration of Specialist Palliative Care in Patients with Advanced Cancer: Randomized Controlled Trial PALINT. \textit{JOURNAL OF PALLIATIVE MEDICINE}. NEW ROCHELLE: MARY ANN LIEBERT, INC, 2020, roč.~23, č.~12, s.~1586-1593. ISSN~1096-6218. Dostupné z: https://dx.doi.org/10.1089/jpm.2019.0697.
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