Exploratory analyses of the Danish Palliative Care Trial (DanPaCT): a randomized trial of early specialized palliative care plus standard care versus standard care in advanced cancer patients

Anna Thit Johnsen, Morten Aagaard Petersen, Per Sjøgren, Lise Pedersen, Mette Asbjoern Neergaard, Anette Damkier, Christian Gluud, Peter Fayers, Jane Lindschou, Annette S Strömgren, Jan Bjoern Nielsen, Irene J Higginson, Mogens Groenvold

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Background: Early and integrated specialized palliative care is often recommended but has still only been investigated in relatively few randomized clinical trials. Objective: To investigate the effect of early specialized palliative care plus standard care versus standard care on the explorative outcomes in the Danish Palliative Care Trial (DanPaCT). Methods: We conducted a randomized multicentre, parallel-group clinical trial. Consecutive patients with metastatic cancer were included if they had symptoms or problems that exceeded a predefined threshold according to the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Outcomes were estimated as the differences between the intervention and the control groups in the change from baseline to the weighted mean of the 3- and 8-week follow-ups measured as areas under the curve. Results: In total, 145 patients were randomized to early specialized palliative care plus standard care versus 152 to standard care only. Early specialized palliative care had no significant effect on any of the symptoms or problems. Of the 21 items addressing satisfaction, specialized palliative care improved the item ‘overall satisfaction with the help received from the health care system’ with 9 points (95% confidence interval 3.8 to 14.2, p = 0.0006) and three other items (all p < 0.05). Conclusion: In line with the analyses of the primary and secondary outcomes in DanPaCT, we did not find that specialized palliative care, as provided in DanPaCT, affected symptoms and problems. However, patients in the intervention group seemed more satisfied with the health care received than those in the standard care group.

OriginalsprogEngelsk
TidsskriftSupportive Care in Cancer
ISSN0941-4355
DOI
StatusE-pub ahead of print - 13. aug. 2019

Fingeraftryk

Palliative Care
Neoplasms
Delivery of Health Care
Area Under Curve
Randomized Controlled Trials
Quality of Life
Clinical Trials
Organizations
Confidence Intervals
Control Groups
Research

Citer dette

Johnsen, Anna Thit ; Petersen, Morten Aagaard ; Sjøgren, Per ; Pedersen, Lise ; Neergaard, Mette Asbjoern ; Damkier, Anette ; Gluud, Christian ; Fayers, Peter ; Lindschou, Jane ; Strömgren, Annette S ; Nielsen, Jan Bjoern ; Higginson, Irene J ; Groenvold, Mogens. / Exploratory analyses of the Danish Palliative Care Trial (DanPaCT) : a randomized trial of early specialized palliative care plus standard care versus standard care in advanced cancer patients. I: Supportive Care in Cancer. 2019.
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title = "Exploratory analyses of the Danish Palliative Care Trial (DanPaCT): a randomized trial of early specialized palliative care plus standard care versus standard care in advanced cancer patients",
abstract = "Background: Early and integrated specialized palliative care is often recommended but has still only been investigated in relatively few randomized clinical trials. Objective: To investigate the effect of early specialized palliative care plus standard care versus standard care on the explorative outcomes in the Danish Palliative Care Trial (DanPaCT). Methods: We conducted a randomized multicentre, parallel-group clinical trial. Consecutive patients with metastatic cancer were included if they had symptoms or problems that exceeded a predefined threshold according to the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Outcomes were estimated as the differences between the intervention and the control groups in the change from baseline to the weighted mean of the 3- and 8-week follow-ups measured as areas under the curve. Results: In total, 145 patients were randomized to early specialized palliative care plus standard care versus 152 to standard care only. Early specialized palliative care had no significant effect on any of the symptoms or problems. Of the 21 items addressing satisfaction, specialized palliative care improved the item ‘overall satisfaction with the help received from the health care system’ with 9 points (95{\%} confidence interval 3.8 to 14.2, p = 0.0006) and three other items (all p < 0.05). Conclusion: In line with the analyses of the primary and secondary outcomes in DanPaCT, we did not find that specialized palliative care, as provided in DanPaCT, affected symptoms and problems. However, patients in the intervention group seemed more satisfied with the health care received than those in the standard care group.",
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Exploratory analyses of the Danish Palliative Care Trial (DanPaCT) : a randomized trial of early specialized palliative care plus standard care versus standard care in advanced cancer patients. / Johnsen, Anna Thit; Petersen, Morten Aagaard; Sjøgren, Per; Pedersen, Lise; Neergaard, Mette Asbjoern; Damkier, Anette; Gluud, Christian; Fayers, Peter; Lindschou, Jane; Strömgren, Annette S; Nielsen, Jan Bjoern; Higginson, Irene J; Groenvold, Mogens.

I: Supportive Care in Cancer, 13.08.2019.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Exploratory analyses of the Danish Palliative Care Trial (DanPaCT)

T2 - a randomized trial of early specialized palliative care plus standard care versus standard care in advanced cancer patients

AU - Johnsen, Anna Thit

AU - Petersen, Morten Aagaard

AU - Sjøgren, Per

AU - Pedersen, Lise

AU - Neergaard, Mette Asbjoern

AU - Damkier, Anette

AU - Gluud, Christian

AU - Fayers, Peter

AU - Lindschou, Jane

AU - Strömgren, Annette S

AU - Nielsen, Jan Bjoern

AU - Higginson, Irene J

AU - Groenvold, Mogens

PY - 2019/8/13

Y1 - 2019/8/13

N2 - Background: Early and integrated specialized palliative care is often recommended but has still only been investigated in relatively few randomized clinical trials. Objective: To investigate the effect of early specialized palliative care plus standard care versus standard care on the explorative outcomes in the Danish Palliative Care Trial (DanPaCT). Methods: We conducted a randomized multicentre, parallel-group clinical trial. Consecutive patients with metastatic cancer were included if they had symptoms or problems that exceeded a predefined threshold according to the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Outcomes were estimated as the differences between the intervention and the control groups in the change from baseline to the weighted mean of the 3- and 8-week follow-ups measured as areas under the curve. Results: In total, 145 patients were randomized to early specialized palliative care plus standard care versus 152 to standard care only. Early specialized palliative care had no significant effect on any of the symptoms or problems. Of the 21 items addressing satisfaction, specialized palliative care improved the item ‘overall satisfaction with the help received from the health care system’ with 9 points (95% confidence interval 3.8 to 14.2, p = 0.0006) and three other items (all p < 0.05). Conclusion: In line with the analyses of the primary and secondary outcomes in DanPaCT, we did not find that specialized palliative care, as provided in DanPaCT, affected symptoms and problems. However, patients in the intervention group seemed more satisfied with the health care received than those in the standard care group.

AB - Background: Early and integrated specialized palliative care is often recommended but has still only been investigated in relatively few randomized clinical trials. Objective: To investigate the effect of early specialized palliative care plus standard care versus standard care on the explorative outcomes in the Danish Palliative Care Trial (DanPaCT). Methods: We conducted a randomized multicentre, parallel-group clinical trial. Consecutive patients with metastatic cancer were included if they had symptoms or problems that exceeded a predefined threshold according to the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Outcomes were estimated as the differences between the intervention and the control groups in the change from baseline to the weighted mean of the 3- and 8-week follow-ups measured as areas under the curve. Results: In total, 145 patients were randomized to early specialized palliative care plus standard care versus 152 to standard care only. Early specialized palliative care had no significant effect on any of the symptoms or problems. Of the 21 items addressing satisfaction, specialized palliative care improved the item ‘overall satisfaction with the help received from the health care system’ with 9 points (95% confidence interval 3.8 to 14.2, p = 0.0006) and three other items (all p < 0.05). Conclusion: In line with the analyses of the primary and secondary outcomes in DanPaCT, we did not find that specialized palliative care, as provided in DanPaCT, affected symptoms and problems. However, patients in the intervention group seemed more satisfied with the health care received than those in the standard care group.

KW - Depression

KW - Neoplasms

KW - Palliative care

KW - Patient satisfaction

KW - Quality of life

KW - Randomized clinical trial

U2 - 10.1007/s00520-019-05021-7

DO - 10.1007/s00520-019-05021-7

M3 - Journal article

C2 - 31410598

JO - Supportive Care in Cancer

JF - Supportive Care in Cancer

SN - 0941-4355

ER -