According to research presented by Prof. Fraser Brims of Curtin University in Australia, early specialist palliative care for patients that were recently diagnosed with malignant pleural mesothelioma ( MPM ) does not impact quality of life ( QOL ) measures. The study was published in the New England Journal of Medicine
Because of the high symptom burden often associated with MPM , Prof. Brims sought to determine if starting palliative care early would impact quality of life. Additionally, a study by Temel et al., Demonstrated a significant difference in reported quality of life in patients with lung cancer who had regular palliative care as compared to control therapy alone.
This led Prof. Brims to consider whether this intervention could lead to similar findings in patients with MPM. The team randomized patients diagnosed with MPM within the last six weeks into two groups – the intervention group received both early specialist palliative care and standard care, while the other group received standard care alone.
Those receiving the early specialist palliative care had to visit every four weeks throughout the study. To determine the impact of the intervention , the authors used the EORTC QLQ-C30 questionnaire for quality of life measurements and the General Health Questionnaire (GHQ-12) for anxiety / depression measurements.
The primary outcome was studied in EORTC C30 Global Health Status QOL 12 weeks after randomization. The results of the international multicenter study indicate that there is no role for routine early referral to palliative care, regardless of symptoms, as there was no impact on quality of life (or mood) in the recently diagnosed MPM patients in the intervention group.
Since the study does not provide clear results on what the optimal timing for referral is, that decision should continue to be based on clinicians' judgment. Future research into this question may be useful to review this practice to ensure optimal use of healthcare resources.
"The finding of esta study different as Compared to the paper Temel May be Explained by the different settings and healthcare systems the studies Were performed in, or can be Explained Perhaps by the different disease," Prof. Said Brims. "While the results were surprising, as intuitively as many of us felt that the intervention was likely to help, they highlight why we need high quality studies like this."