The emergency department point of palliative care access for patients with advanced cancer
Mené aux Etats-Unis auprès de 136 participants, cet essai randomisé analyse la qualité de vie, les symptômes de dépression et la survie chez des patients atteints d'un cancer de stade avancé, et recevant des soins palliatifs mis en oeuvre par un service d'urgences
The highly desirable outcomes of more frequent and earlier access to palliative care are currently not available for most patients with advanced cancer. However, a number of conceptual models for this integration have been developed, including a time-based model, a clinician-based model, a problem-based model, and a system-based model.4 These conceptual models require important clinical sentinel events (eg, hypercalcemia, brain metastases, poor symptom control) as triggers for the palliative care consultation. In the current issue of JAMA Oncology, Grudzen et al5 have demonstrated in an elegant randomized clinical trial that using the emergency department (ED) visit as a sentinel event for a palliative care referral can improve quality of life with no detrimental effects on health services use or survival.
JAMA Oncology , éditorial, 2015