Haematological malignancy: are patients appropriately referred for specialist palliative and hospice care? A systematic review and meta-analysis of published data
Top Cited Papers
- 12 January 2011
- journal article
- review article
- Published by SAGE Publications in Palliative Medicine
- Vol. 25 (6), 630-641
- https://doi.org/10.1177/0269216310391692
Abstract
Haematological malignancies are complex diseases, affecting the entire age spectrum, and having marked differences in presentation, treatment, progression and outcome. Patients have a significant symptom burden and despite treatment improvements for some sub-types, many patients die from their disease. We carried out a systematic review and meta-analysis to examine the proportion of patients with haematological malignancies that received any form of specialist palliative or hospice care. Twenty-four studies were identified, nine of which were suitable for inclusion in the meta-analysis. Our review showed that patients with haematological malignancies were far less likely to receive care from specialist palliative or hospice services compared to other cancers (Risk Ratio 0.46, [95% confidence intervals 0.42–0.50]). There are several possible explanations for this finding, including: ongoing management by the haematology team and consequent strong bonds between staff and patients; uncertain transitions to a palliative approach to care; and sudden transitions, leaving little time for palliative input. Further research is needed to explore: transitions to palliative care; potential unmet patient needs; where patients want to be cared for and die; existing practices in the delivery of palliative and end-of-life care; and barriers to specialist palliative care and hospice referral and how these might be overcome.Keywords
This publication has 45 references indexed in Scilit:
- Destined to die in hospital? Systematic review and meta-analysis of place of death in haematological malignancyBMC Palliative Care, 2010
- The Haematological Malignancy Research Network (HMRN): a new information strategy for population based epidemiology and health service researchBritish Journal of Haematology, 2010
- GPs' awareness of patients' preference for place of deathBritish Journal of General Practice, 2009
- Health related quality of life in a nationally representative sample of haematological patientsEuropean Journal of Haematology, 2009
- Aggressiveness of Cancer Care Near the End of Life: Is It a Quality-of-Care Issue?Journal of Clinical Oncology, 2008
- Inequity in the provision of and access to palliative care for cancer patients. Results from the Italian survey of the dying of cancer (ISDOC)BMC Public Health, 2007
- Patterns and Predictors of Home Health and Hospice Use by Older Adults with CancerJournal of the American Geriatrics Society, 2006
- Trends in the Treatment of Acute Myeloid Leukaemia in the ElderlyDrugs & Aging, 2005
- Which terminally ill cancer patients in the United Kingdom receive care from community specialist palliative care nurses?Journal of Advanced Nursing, 2000
- Characteristics of deaths in a department of oncohaematology within a general hospitalSupportive Care in Cancer, 2000