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Home-based specialized palliative care in patients with advanced cancer: A systematic review

Published online by Cambridge University Press:  13 July 2016

Mie Nordly ,
Eva Soelberg Vadstrup ,
Per Sjøgren  and
Geana Paula Kurita
Mie Nordly*
Affiliation:
Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
Eva Soelberg Vadstrup
Affiliation:
Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Per Sjøgren
Affiliation:
Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
Geana Paula Kurita
Affiliation:
Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark Multidisciplinary Pain Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
*
Address correspondence and reprint requests to Mie Nordly, Department of Oncology, Rigshospitalet, Blegdamsvej 9, Department 7621, 2100 Copenhagen, Denmark. E-mail: mie.nordly@regionh.dk.
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Abstract

Objective:

Due to an urgent need for specialized palliative care (SPC) for patients with advanced cancer, an overview of available information on organization and outcomes of home-based SPC would be valuable. Our systematic review aims to give an overview of available information on the organization and outcomes of home-based SPC for patients with advanced cancer. Outcomes related to place of death, survival time, quality of life, performance status, and symptom management are included.

Method:

A PICO process search strategy consisting of terms related to cancer, palliation, and home care was employed. The search was conducted in PubMed, EMBASE, and Cochrane from January 1, 2000, to January 27, 2015. A hand search of the reference lists of the included studies was also performed.

Results:

A total of 5 articles (out of 2080 abstracts) were selected for analysis. Three additional studies were added by the hand search. Six observational and two interventional studies were evaluated. In all of these studies, the description of the SPC service was limited to the composition of the staff—no other organizational aspects were detailed. From 44 to 90% of the patients receiving home-based SPC died at home. Studies including survival and quality of life had divergent outcomes, and overall performance status did not improve. However, symptom control did improve over time.

Significance of results:

There is a lack of controlled clinical trials and organizational descriptions regarding home-based SPC for patients with advanced cancer, resulting in poor information and a lack of evidence. Generally, home-based SPC seems to have some positive effect on pain and dyspnea, but more high-quality studies are required.

Keywords

CancerPalliative careHome careReviewHome deathsSymptoms
Type
Review Article
Information
Palliative & Supportive Care , Volume 14 , Issue 6 , December 2016 , pp. 713 - 724
Copyright
Copyright © Cambridge University Press 2016 

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