TThis sought to determine how quality of life and survival would be affected if a palliative care consultation was started in the emergency department rather then
The report, published in JAMA Oncology February 2016, found that the ED consultation led to improved quality of life with no statistically significant effect on survival rates.
For the study, a New York University-led study team conducted a randomized clinical trial to compare quality of life, depression, healthcare utilization, and survival in ED patients with advanced cancer randomly assigned to an intervention with an ED-initiated palliative care consultation as opposed to usual care.
Of the 136 participants, 69 patients were in the palliative care consultation intervention and 67 in usual care, where they might also may have received a palliative care consultation if it was requested by the admitting team or an oncologist. Among the 69 patients in the intervention, 41 died by the end of a year, as did 44 of the 67 patients who received usual care.
Results indicate that the ED palliative care intervention was associated with increased quality-of-life scores from study enrollment to week 12 – an average increase of 5.91 points in the intervention vs. an increase of 1.08 in the usual care group.
In addition, median survival was longer for patients in the intervention at 289 days, compared with the usual care group, 132 days, although the difference was not statistically significant because of the extremely variable length of survival in the study group.
