Choosing Wisely:

Don’t delay palliative care for patients with a serious illness who have physical, psychological, social, or spiritual distress because they are pursuing disease-directed treatment.

Rationale and Comments: Numerous studies—including randomized trials—provide evidence that palliative care improves pain and symptom control, improves family satisfaction with care, and reduces costs. Palliative care does not accelerate death, and may prolong life in selected populations.
Sponsoring Organizations:
  • American Academy of Hospice and Palliative Medicine
  • Sources:
  • Randomized controlled trials
  • Disciplines:
  • Geriatric Medicine
  • References: • Delgado-Guay MO, et al. Symptom distress, intervention, and outcomes of intensive care unit cancer patients referred to a palliative care consult team. Cancer. 2009;115:437-45.
    • Elsayem A, et al. Impact of a palliative care service on in-hospital mortality in a comprehensive cancer center. J Pall Med. 2006;9:894-902.
    • Elsayem A, et al. Palliative care inpatient services in a comprehensive cancer center: clinical and financial outcomes. J Clin Oncol. 2004;22(10):2008-14.
    • Gelfman LP, et al. Does palliative care improve quality? A survey of bereaved family members. J Pain Symptom Manage. 2008;36:22-8.
    • Higginson IJ, et al. Is there evidence that palliative care teams alter end-of-life experiences of patients and their caregivers? J Pain Symptom Manage. 2003;25:150-68.
    • Jordhoy MS, et al. A palliative care intervention and death at home: A cluster randomized trial. Lancet. 2000;356(9233): 888-93.
    • London MR, et al. Evaluation of a comprehensive, adaptable, life-affirming, longitudinal (CALL) palliative care project. J Pall Med. 2005;8:1214-25.
    • Temel JS, et al. Early palliative care for patients with metastatic non-small cell lung cancer. N Engl J Med. 2010;363:733-42.

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