PITTSBURGH _ A University of Pittsburgh-based study examining dozens of prior palliative care research findings suggests the patient-focused, pain-reducing treatment accomplishes its major goals, but not necessarily with the tantalizing bonus that it extends life.
The study led by Pitt assistant professor of medicine Dio Kavalieratos, which was published in Tuesday's Journal of the American Medical Association, found people with serious illness reported better quality of life and fewer symptoms if they had received palliative treatment.
Those findings came from a team's thorough review of results from 43 different trials through the years concerning palliative care interventions. Those findings represent a "very compelling message" about the benefits of palliative care, said Kavalieratos, but he said there was insufficient evidence to support some individual trials' findings that palliative care had helped people live longer.
"There have been a couple of really high-profile studies in the past five or so years that have shown improved survival after receiving palliative care. ... We just didn't find an association at all," said Kavalieratos, who works in the Section of Palliative Care and Medical Ethics at Pitt.
Palliative care, often linked to late-life hospice care but not the same thing, is a relatively young medical specialty that focuses on pain management and other methods of assisting patients' comfort without giving up treatment of their illness. The majority of hospitals now have palliative care teams, with much of their work devoted to cancer patients but also an increasing number of individuals with other serious illnesses.
Kavalieratos said the findings relating to survival were not distressing, in that palliative care exists more for the aspects that were validated in the team's meta-analysis of dozens of studies.
"The stated goals of palliative care are to improve quality of life and reduce stress _ improved survival is not a stated goal of palliative care," he said. "A couple of studies have found (improved survival), but when it's been reported it's been as an 'aside' kind of finding that's gotten a lot of attention. We didn't go in hoping to show palliative care is associated with survival, because that's not a stated outcome."
Among other consensus findings identified in the new paper, based on prior studies, are that palliative care can be linked to improved advanced care planning; satisfaction with care by both patients and caregivers; and lower health care utilization.
The study found insufficient evidence, however, to say that palliative care produces improvements in patient moods, health care expenditures, caregiver quality of life and in patient deaths occurring where they prefer _ typically at home instead of in institutions.
