Palliative Care Offers Substantial Benefits, But Improved Survival Not One of Them
While palliative care interventions improve patients' quality of life, there is no survival benefit.
A meta-analysis of randomized clinical trials of palliative care interventions in adults with life-limiting illnesses was conducted to determine the association of palliative care with quality of life (QOL), symptom burden, survival, mood, advance care planning, site of death, healthcare satisfaction, resource utilization, and healthcare expenditures.
Forty-three trials provided data on 12,731 patients and 2479 caregivers. Thirty-five trials used usual care as the control, and 14 took place in the ambulatory setting. Palliative care was associated with significant improvements in patient QOL and symptom burden at the 1- to 3-month follow-ups.
There was no association between palliative care and survival, however. Palliative care was associated with improvements in advance care planning, patient and caregiver satisfaction, and lower healthcare utilization.
Although the researchers concluded that palliative care was associated with improvements in QOL and symptom burden but not with improved survival, isn’t that the point of palliative care? To imply that palliative care should improve survival is misleading. A more accurate conclusion is that as expected, palliative care did not extend patients’ survival; however, it improved the patients QOL and reduced their symptom burden. The study findings are available here.