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01-05-2020 | Mood Disorders | Original Article

Exploratory analyses of the Danish Palliative Care Trial (DanPaCT): a randomized trial of early specialized palliative care plus standard care versus standard care in advanced cancer patients

Authors: Anna Thit Johnsen, Morten Aagaard Petersen, Per Sjøgren, Lise Pedersen, Mette Asbjoern Neergaard, Anette Damkier, Christian Gluud, Peter Fayers, Jane Lindschou, Annette S. Strömgren, Jan Bjoern Nielsen, Irene J. Higginson, Mogens Groenvold

Published in: Supportive Care in Cancer | Issue 5/2020

Abstract

Background

Early and integrated specialized palliative care is often recommended but has still only been investigated in relatively few randomized clinical trials.

Objective

To investigate the effect of early specialized palliative care plus standard care versus standard care on the explorative outcomes in the Danish Palliative Care Trial (DanPaCT).

Methods

We conducted a randomized multicentre, parallel-group clinical trial. Consecutive patients with metastatic cancer were included if they had symptoms or problems that exceeded a predefined threshold according to the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Outcomes were estimated as the differences between the intervention and the control groups in the change from baseline to the weighted mean of the 3- and 8-week follow-ups measured as areas under the curve.

Results

In total, 145 patients were randomized to early specialized palliative care plus standard care versus 152 to standard care only. Early specialized palliative care had no significant effect on any of the symptoms or problems. Of the 21 items addressing satisfaction, specialized palliative care improved the item ‘overall satisfaction with the help received from the health care system’ with 9 points (95% confidence interval 3.8 to 14.2, p = 0.0006) and three other items (all p < 0.05).

Conclusion

In line with the analyses of the primary and secondary outcomes in DanPaCT, we did not find that specialized palliative care, as provided in DanPaCT, affected symptoms and problems. However, patients in the intervention group seemed more satisfied with the health care received than those in the standard care group.

Trial registration

NCT01348048

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Title: Exploratory analyses of the Danish Palliative Care Trial (DanPaCT): a randomized trial of early specialized palliative care plus standard care versus standard care in advanced cancer patients
Authors: Anna Thit Johnsen
Morten Aagaard Petersen
Per Sjøgren
Lise Pedersen
Mette Asbjoern Neergaard
Anette Damkier
Christian Gluud
Peter Fayers
Jane Lindschou
Annette S. Strömgren
Jan Bjoern Nielsen
Irene J. Higginson
Mogens Groenvold
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keywords: Mood Disorders
Care
Affective Disorder
Published in: Supportive Care in Cancer / Issue 5/2020
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-019-05021-7

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