Which patients experience improved quality of life (QOL) and mood from early palliative care (PC)?

Abstract

16 Background: Prior research has demonstrated improved patient outcomes with early PC integrated with standard oncology care (SC), but it is not clear if these associations exist in all patient demographic groups. This study examined whether early integrated PC was associated with improvements in QOL and mood in different demographic groups. Methods: This is a secondary analysis of data from a randomized controlled trial of 151 patients with newly diagnosed metastatic non-small-cell lung cancer presenting to an outpatient cancer center from June 2006 to July 2009. Patients received either early PC integrated with SC or SC alone. QOL (Functional Assessment of Cancer Therapy–Lung [FACT-L] and Trial Outcome Index [TOI]) and mood (Hospital Anxiety and Depression Scale depression subscale [HADS-D] and Patient Health Questionnaire 9 [PHQ-9], scored categorically) were assessed at baseline and 12 weeks. Data were analyzed to assess relationships between outcome variables and patient demographic characteristics (age and gender). Results: At baseline, QOL and mood outcomes did not differ significantly between treatment groups for age or gender. At 12 weeks, the PC group showed better QOL and lower rates of depressive symptoms for males and those < age 65. In comparison, QOL and mood did not differ significantly between study groups for females and those ≥ age 65. Conclusions: Males and patients < age 65 experienced improved QOL and mood with early, integrated PC. However, these outcomes did not differ significantly between treatment groups for patients ≥ age 65 or for females. Further research should confirm these findings and tailor interventions to meet the unique needs of all patients with cancer. [Table: see text]