• Steffen Eychmüller, Susanne Zwahlen, Monica C Fliedner, Peter Jüni, Daniel M Aebersold, Drahomir Aujesky, Martin F Fey, Maud Maessen, and Sven Trelle.
• University Center for Palliative Care, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
• Palliat Med. 2021 Jun 1; 35 (6): 1108-1117.

BackgroundInternational oncology societies recommend early palliative care. Specific models to integrate early palliative care efficiently into clinical practice are debated. The authors designed a study to look at the quantitative and qualitative outcomes of an early palliative care intervention in oncological care to decrease stress and improve quality of life.AimsTo compare a single structured early palliative care intervention added to a usual oncology care in terms of distress and health-related quality of life at baseline compared to 6 months after enrollment.DesignThis multicenter randomized controlled trial (NCT01983956) enrolled adult patients with advanced cancer. Participants were either randomly assigned to usual oncology care alone or usual care plus a structured early palliative care intervention.Setting/ParticipantsOne hundred fifty adult patients with a variety of advanced cancer diagnoses were randomized. Seventy-four participants were in the intervention and 76 participants in the control group. The primary outcome was the change in patient distress assessed by the National Comprehensive Cancer Network distress thermometer at 6 months. Health-related quality of life, the secondary outcome, was assessed by the Functional Assessment of Cancer Therapy-General Questionnaire.ResultsThe results showed no significant effect of the early palliative care intervention neither on patient distress nor on health-related quality of life.ConclusionThe addition of an early intervention to usual care for patients with advanced cancer did not improve distress or quality of life. Thus, patients may need more intensive early palliative care with continuous professional support to identify and address their palliative needs early.

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