Abstract
BackgroundPain is one of the most common symptoms that has a severe impact on quality of life and is associated with numerous psychosocial issues in cancer patients. Palliative care, which is a recent development in China, mainly focuses on symptom control and provides psychosocial support in order to improve quality of life for terminally ill patients. This meta-analysis aimed to evaluate the effects of palliative care on cancer pain in China.MethodsThe four most comprehensive Chinese academic databases-CNKI, Wanfang, Vip and CBM-were searched from their inception until July 2019. Medline/PubMed, Web of Science, EBSCO and internet search (Google and Google Scholar) were also searched. Randomized controlled studies assessing the effects of palliative care on cancer pain were analyzed. The pooled random-effect estimates of standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated. Subgroup analysis was conducted by moderating factors for heterogeneity.ResultsThe present meta-analysis included 18 studies with a total of 1370 patients. The random-effect model showed a significant effect size of palliative care on cancer pain (SMD = 1.475, p < 0.001; 95% CI = 1.071–1.878). Age, pharmacological/non-pharmacological strategies and publication date could account for the heterogeneity through subgroup analysis to some extent.ConclusionsPalliative care was largely effective for relieving pain among Chinese adults with cancer, indicating that an adequate system should be urgently established to provide palliative care for cancer patients in Chinese medical settings. However, given the extent of heterogeneity, our findings should be interpreted cautiously.
Highlights
Pain is one of the most common symptoms that has a severe impact on quality of life and is associated with numerous psychosocial issues in cancer patients
Contrary to traditional oncologic care, advanced cancer patients received the treatment with palliative intent and the main emphasis placed on palliative care (PC) in some settings [5]
The randomized controlled trials (RCTs) of PC paid more attention to the evaluation of quality of life, symptom burden and psychological distress [8,9,10], and systematic reviews mainly focused on the prevalence rate and severity of cancer pain [1, 11]
Summary
Pain is one of the most common symptoms that has a severe impact on quality of life and is associated with numerous psychosocial issues in cancer patients. Palliative care, which is a recent development in China, mainly focuses on symptom control and provides psychosocial support in order to improve quality of life for terminally ill patients. This meta-analysis aimed to evaluate the effects of palliative care on cancer pain in China. The randomized controlled trials (RCTs) of PC paid more attention to the evaluation of quality of life, symptom burden and psychological distress [8,9,10], and systematic reviews mainly focused on the prevalence rate and severity of cancer pain [1, 11]. To the best of our knowledge, few meta-analysis of RCTs have evaluated the effects of PC on cancer pain
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