Palliative Care in Hematology: A Systematic Review of the Components, Effectiveness, and Implementation

Sophie Hochrath; Naomi Marcella R Dhollander; Luc Deliens; Rik Schots; Frederick Daenen; Tessa Kerre; Kim Beernaert; Koen Pardon

doi:10.1016/j.jpainsymman.2024.08.025

Palliative Care in Hematology: A Systematic Review of the Components, Effectiveness, and Implementation

Sophie Hochrath, Naomi Marcella R Dhollander, Luc Deliens, Rik Schots, Frederick Daenen, Tessa Kerre, Kim Beernaert, Koen Pardon

Research output: Contribution to journal › Article › peer-review

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Abstract

Context: While the evidence supporting the benefits of integration of palliative care into cancer care for patients and informal caregivers is growing, it poses challenges for hematological cancer patients due to rapidly changing disease trajectories, uncertain prognosis, and diverse care needs.

Objectives: This systematic review aims to provide an overview of the intervention components, the targeted outcomes, the effectiveness in improving patient and informal caregiver outcomes, and the implementation into clinical practice.

Methods: We systematically searched PubMed (MEDLINE), EMBASE, CENTRAL, PsycINFO, and CINAHL in March 2023. The studies included described interventions in palliative care, with multiple components, targeting patients with hematological cancer and/or their informal caregivers, and producing primary data on effectiveness or implementation. Quality was assessed using the QualSyst tool.

Results: We identified 19 reports on 16 different palliative care interventions, including 4 quasi-randomized controlled trials. These interventions were provided by secondary and tertiary palliative care providers in a hospital setting. Tertiary interventions significantly improved the most common patient outcomes, including pain, quality of life, symptom burden, depression, and anxiety. Meanwhile, secondary interventions were feasible and well-accepted by healthcare professionals and patients. Despite limited inclusion of informal caregivers, the results indicated significant improvements in quality of life and depression.

Conclusion: While palliative care interventions are found to improve patient outcomes, future research is needed on the effectiveness of secondary palliative care interventions, integrating primary palliative care, and more reliable and frequent implementation measurements. More focus on informal caregivers and resource allocation based on patient needs is warranted.

Original language	English
Pages (from-to)	114-133.e2
Number of pages	22
Journal	Journal of Pain and Symptom Management
Volume	69
Issue number	1
DOIs	https://doi.org/10.1016/j.jpainsymman.2024.08.025
Publication status	Published - Jan 2025

Bibliographical note

Funding Information:
The authors confirm that there are no potential conflicts of interest concerning authorship or publication of this manuscript. All authors have thoroughly read and approved the manuscript and consent to its submission to JPSM. This manuscript has not been submitted or published elsewhere. During the preparation of this work the author(s) used OpenAI in order to make sentences or small parts of paragraphs more concise or easier to read. After using this tool/service, the primary author reviewed and edited the content as needed and takes full responsibility for the content of the publication. We would like to thank Katrien Alewaeters, head of the medical library and library information specialist, for supporting us in developing and evaluating the search string, and Lise Rosquin for taking the time to proofread this systematic review. Kom op Tegen Kanker (grant number: KOTK/2022/12451).

Publisher Copyright:
© 2024 American Academy of Hospice and Palliative Medicine

Keywords

Hematology
Palliative Care
Systematic Review
patient outcome
Implementation

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Cite this

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title = "Palliative Care in Hematology: A Systematic Review of the Components, Effectiveness, and Implementation",

abstract = "Context: While the evidence supporting the benefits of integration of palliative care into cancer care for patients and informal caregivers is growing, it poses challenges for hematological cancer patients due to rapidly changing disease trajectories, uncertain prognosis, and diverse care needs. Objectives: This systematic review aims to provide an overview of the intervention components, the targeted outcomes, the effectiveness in improving patient and informal caregiver outcomes, and the implementation into clinical practice.Methods: We systematically searched PubMed (MEDLINE), EMBASE, CENTRAL, PsycINFO, and CINAHL in March 2023. The studies included described interventions in palliative care, with multiple components, targeting patients with hematological cancer and/or their informal caregivers, and producing primary data on effectiveness or implementation. Quality was assessed using the QualSyst tool. Results: We identified 19 reports on 16 different palliative care interventions, including 4 quasi-randomized controlled trials. These interventions were provided by secondary and tertiary palliative care providers in a hospital setting. Tertiary interventions significantly improved the most common patient outcomes, including pain, quality of life, symptom burden, depression, and anxiety. Meanwhile, secondary interventions were feasible and well-accepted by healthcare professionals and patients. Despite limited inclusion of informal caregivers, the results indicated significant improvements in quality of life and depression. Conclusion: While palliative care interventions are found to improve patient outcomes, future research is needed on the effectiveness of secondary palliative care interventions, integrating primary palliative care, and more reliable and frequent implementation measurements. More focus on informal caregivers and resource allocation based on patient needs is warranted. ",

keywords = "Hematology, Palliative Care, Systematic Review, patient outcome, Implementation",

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note = "Funding Information: The authors confirm that there are no potential conflicts of interest concerning authorship or publication of this manuscript. All authors have thoroughly read and approved the manuscript and consent to its submission to JPSM. This manuscript has not been submitted or published elsewhere. During the preparation of this work the author(s) used OpenAI in order to make sentences or small parts of paragraphs more concise or easier to read. After using this tool/service, the primary author reviewed and edited the content as needed and takes full responsibility for the content of the publication. We would like to thank Katrien Alewaeters, head of the medical library and library information specialist, for supporting us in developing and evaluating the search string, and Lise Rosquin for taking the time to proofread this systematic review. Kom op Tegen Kanker (grant number: KOTK/2022/12451). Publisher Copyright: {\textcopyright} 2024 American Academy of Hospice and Palliative Medicine",

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AU - Hochrath, Sophie

AU - Dhollander, Naomi Marcella R

AU - Deliens, Luc

AU - Schots, Rik

AU - Daenen, Frederick

AU - Kerre, Tessa

AU - Beernaert, Kim

AU - Pardon, Koen

N1 - Funding Information: The authors confirm that there are no potential conflicts of interest concerning authorship or publication of this manuscript. All authors have thoroughly read and approved the manuscript and consent to its submission to JPSM. This manuscript has not been submitted or published elsewhere. During the preparation of this work the author(s) used OpenAI in order to make sentences or small parts of paragraphs more concise or easier to read. After using this tool/service, the primary author reviewed and edited the content as needed and takes full responsibility for the content of the publication. We would like to thank Katrien Alewaeters, head of the medical library and library information specialist, for supporting us in developing and evaluating the search string, and Lise Rosquin for taking the time to proofread this systematic review. Kom op Tegen Kanker (grant number: KOTK/2022/12451). Publisher Copyright: © 2024 American Academy of Hospice and Palliative Medicine

PY - 2025/1

Y1 - 2025/1

N2 - Context: While the evidence supporting the benefits of integration of palliative care into cancer care for patients and informal caregivers is growing, it poses challenges for hematological cancer patients due to rapidly changing disease trajectories, uncertain prognosis, and diverse care needs. Objectives: This systematic review aims to provide an overview of the intervention components, the targeted outcomes, the effectiveness in improving patient and informal caregiver outcomes, and the implementation into clinical practice.Methods: We systematically searched PubMed (MEDLINE), EMBASE, CENTRAL, PsycINFO, and CINAHL in March 2023. The studies included described interventions in palliative care, with multiple components, targeting patients with hematological cancer and/or their informal caregivers, and producing primary data on effectiveness or implementation. Quality was assessed using the QualSyst tool. Results: We identified 19 reports on 16 different palliative care interventions, including 4 quasi-randomized controlled trials. These interventions were provided by secondary and tertiary palliative care providers in a hospital setting. Tertiary interventions significantly improved the most common patient outcomes, including pain, quality of life, symptom burden, depression, and anxiety. Meanwhile, secondary interventions were feasible and well-accepted by healthcare professionals and patients. Despite limited inclusion of informal caregivers, the results indicated significant improvements in quality of life and depression. Conclusion: While palliative care interventions are found to improve patient outcomes, future research is needed on the effectiveness of secondary palliative care interventions, integrating primary palliative care, and more reliable and frequent implementation measurements. More focus on informal caregivers and resource allocation based on patient needs is warranted.

AB - Context: While the evidence supporting the benefits of integration of palliative care into cancer care for patients and informal caregivers is growing, it poses challenges for hematological cancer patients due to rapidly changing disease trajectories, uncertain prognosis, and diverse care needs. Objectives: This systematic review aims to provide an overview of the intervention components, the targeted outcomes, the effectiveness in improving patient and informal caregiver outcomes, and the implementation into clinical practice.Methods: We systematically searched PubMed (MEDLINE), EMBASE, CENTRAL, PsycINFO, and CINAHL in March 2023. The studies included described interventions in palliative care, with multiple components, targeting patients with hematological cancer and/or their informal caregivers, and producing primary data on effectiveness or implementation. Quality was assessed using the QualSyst tool. Results: We identified 19 reports on 16 different palliative care interventions, including 4 quasi-randomized controlled trials. These interventions were provided by secondary and tertiary palliative care providers in a hospital setting. Tertiary interventions significantly improved the most common patient outcomes, including pain, quality of life, symptom burden, depression, and anxiety. Meanwhile, secondary interventions were feasible and well-accepted by healthcare professionals and patients. Despite limited inclusion of informal caregivers, the results indicated significant improvements in quality of life and depression. Conclusion: While palliative care interventions are found to improve patient outcomes, future research is needed on the effectiveness of secondary palliative care interventions, integrating primary palliative care, and more reliable and frequent implementation measurements. More focus on informal caregivers and resource allocation based on patient needs is warranted.

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Palliative Care in Hematology: A Systematic Review of the Components, Effectiveness, and Implementation

Abstract

Bibliographical note

Keywords

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BASGO17: OZR Basisfinanciering voor Grote Onderzoeksgroepen - EOLC

SRP69: SRP-Onderzoekszwaartepunt: Addressing the challenges around serious illness, palliative care and the end of life: public health, health services and clinical innovations

ANI309: HePaC: towards an optimal integration of palliative care for patients with haematolo-gic cancer