Journal of Pain and Symptom Management
Volume 40, Issue 5 , Pages 652-660 , November 2010

Effectiveness of Palliative Care Services in Symptom Control of Patients with Advanced Terminal Cancer: A Spanish, Multicenter, Prospective, Quasi-Experimental, Pre-Post Study

  • Xavier Gómez-Batiste, MD, PhD

      Affiliations

    • World Health Organization Collaborating Center for Public Health Palliative Care Programs, Catalan Institute of Oncology, Barcelona, Spain
    • Corresponding Author InformationAddress correspondence to: Xavier Gómez-Batiste, MD, PhD, Catalan Institute of Oncology, WHO Collaborating Center for Palliative Care Public Health Programs, Av. Gran Via 199, 08907 L'Hospitalet, Barcelona, Spain.
    • ,
  • Josep Porta-Sales, MD, PhD

      Affiliations

    • Palliative Care Service, Catalan Institute of Oncology, Barcelona, Spain
    • ,
  • Jose Espinosa-Rojas, MD

      Affiliations

    • World Health Organization Collaborating Center for Public Health Palliative Care Programs, Catalan Institute of Oncology, Barcelona, Spain
    • ,
  • Antonio Pascual-López, MD, PhD

      Affiliations

    • National Strategy for Palliative Care, Agency for Quality, Ministry of Health, Madrid, Spain
    • ,
  • Albert Tuca, MD

      Affiliations

    • Palliative Care Service, Catalan Institute of Oncology, Barcelona, Spain
    • ,
  • José Rodriguez, RN

      Affiliations

    • National Strategy for Palliative Care, Agency for Quality, Ministry of Health, Madrid, Spain

,Accepted 22 February 2010.

References 

  1. Centeno C, Heller KS. Palliative care in Spain: an evolving model. J Palliat Med. 2000;3:123–127
  2. Gómez-Batiste X, Tuca A, Corrales E, et al. Resource consumption and costs of palliative care services in Spain: a prospective multicenter study. J Pain Symptom Manage. 2006;31:522–532
  3. Serra-Prat M, Gallo P, Picaza JM. Home palliative care as a cost-saving alternative: evidence from Catalonia. Palliat Med. 2001;15:271–278
  4. Jordhoy MS, Fayers P, Saltnes T, et al. A palliative-care intervention and death at home: a cluster randomised trial. Lancet. 2000;356:888–893
  5. Herrera E, Rocafort J, De Lima L, et al. Regional palliative care program in Extremadura: an effective public health care model in a sparsely populated region. J Pain Symptom Manage. 2007;33:591–598
  6. Hearn J, Higginson IJ. Do specialist palliative care teams improve outcomes for cancer patients? A systematic literature review. Palliat Med. 1998;12:317–332
  7. Higginson IJ, Finlay IG, Goodwin DM, et al. Is there evidence that palliative care teams alter end-of-life experiences of patients and their caregivers?. J Pain Symptom Manage. 2003;25:150–168
  8. Mercadante S, Fulfaro F, Casuccio A. The impact of home palliative care on symptoms in advanced cancer patients. Support Care Cancer. 2000;8:307–310
  9. Porta-Sales J, Codorniu N, Gómez-Batiste X, et al. Patient appointment process, symptom control and prediction of follow-up compliance in a palliative care outpatient clinic. J Pain Symptom Manage. 2005;30:145–153
  10. Bruera E, Kuehn N, Miller M, Selmser P, MacMillan K. The Edmonton Symptom Assessment System (ESAS): simple method for assessment of palliative care patients. J Palliat Care. 1991;7:6–9
  11. de Haes JC, van Knippenberg F, Neijt J. Measuring psychological and physical distress in cancer patients: structure and application of the Rotterdam Symptom Checklist. Br J Cancer. 1990;62:1034–1038
  12. Ewing G, Todd C, Rogers M, et al. Validation of a symptom measure suitable for use among palliative care patients in the community: CAMPAS-R. J Pain Symptom Manage. 2004;27:287–299
  13. Gómez Batiste X, Tuca A, Porta-Sales J. [Multicentered research in palliative care: the initial experience of the Catpal group]. [Spanish]. In:  Gómez-Batiste X,  Porta-Sales J,  Tuca A,  Stjernswärd J editor. Organización de Servicios y Programas de Cuidados Paliativos. Bases de organización, planificación, evaluación y mejora de calidad. ICO Formación Series. 3:Madrid, Spain: Aran Ediciones; 2005;p. 103–109
  14. Porta J, Ylla-Catalá E, Estibalez A, et al. [Catalan-Balearic multicentered study on terminal sedation in palliative care]. [Spanish]. Med Pal (Madrid). 1999;6:153–158
  15. Tuca A, Roca R, Sala C, et al. Efficacy of granisetron in the antiemetic control of nonsurgical intestinal obstruction: a phase II clinical trial. J Pain Symptom Manage. 2009;37:259–270
  16. Gomez-Batiste X, Madrid F, Moreno F, et al. Breakthrough cancer pain: prevalence and characteristics in patients in Catalonia, Spain. J Pain Symptom Manage. 2002;24:45–52
  17. Simon S, Higginson IJ. Evaluation of hospital palliative care teams: strengths and weaknesses of the before-after study design and strategies to improve it. Palliat Med. 2009;23:23–28
  18. Salisbury C, Bosanquet N, Wilkinson EK, et al. The impact of different models of specialist palliative care on patients’ quality of life: a systematic literature review. Palliat Med. 1999;13:3–17
  19. García-Pérez L, Linertová R, Martín-Olivera R, Serrano-Aguilar P, Benítez Rosario MA. A systematic review of specialised palliative care for terminal patients: which model is better?. Palliat Med. 2009;23:17–22
  20. Estrategia Cuidados Paliativos del Sistema Nacional de salud. 2007. Ministerio Sanidad y Consumo, Madrid. Available from www.estrategiaencuidadospaliativos.es.
  21. Caraceni A, Cherny N, Fainsinger R, et al. the Steering Committee of the EAPC Research Network Pain measurement tools and methods in clinical research in palliative care: recommendations of an expert working group of the European Association of Palliative Care. J Pain Symptom Manage. 2002;23:239–255
  22. Centeno C, Noguera A, López B, Carvajal A. Algunos instrumentos de evaluación utilizados en Cuidados Paliativos (I): el cuestionario de evaluación de síntomas de Edmonton (ESAS). Med Pal (Madrid). 2004;11:239–245
  23. Mercadante S. Pain treatment and outcomes for patients with advanced cancer who receive follow-up care at home. Cancer. 1999;85:1849–1858
  24. Gómez Batiste X. [Definition of terminal disease and terminal patient in cancer patients]. [Spanish]. In:  Gómez-Batiste X,  Porta-Sales J,  Tuca A,  Stjernswärd J editor. Organización de Servicios y Programas de Cuidados Paliativos. Bases de organización, planificación, evaluación y mejora de calidad. ICO Formación Series. 1:Madrid, Spain: Aran Ediciones; 2005;p. 21–32
  25. Barreto P, Bayés R, Comas MD, et al. Assessment of the perception and worries in terminally ill patients in Spain. J Palliat Care. 1996;12:43–46
  26. Dudgeon DJ, Harlos M, Clinch JJ. The Edmonton Symptom Assessment Scale (ESAS) as an audit tool. J Palliat Care. 1999;15:14–19
  27. Brechtl JR, Murshed M, Homel P, Bookbinder M. Monitoring symptoms in patients with advanced illness in long-term care: a pilot study. J Pain Symptom Manage. 2006;32:168–174
  28. Modonesi C, Scarpi E, Maltoni M, et al. Impact of palliative care unit admission on symptom control evaluated by the Edmonton Symptom Assessment System. J Pain Symptom Manage. 2005;30:367–373
  29. Follwell M, Burman D, Le LW, et al. Phase II study of an outpatient palliative care intervention in patients with metastatic cancer. J Clin Oncol. 2009;27:206–213
  30. Porta-Sales J, Garzón-Rodriguez C, Fernández-Ortega A, Gómez-Batiste X. [Epidemiology of oncological pain: a review]. [Spanish]. Med Pal (Madrid). 2008;15:307–314
  31. Ventafridda V, Tamburini M, Caraceni A, De Conno F, Naldi F. A validation study of the WHO method for cancer pain relief. Cancer. 1987;59:850–856
  32. Azevedo São Leão Ferreira K, Kimura M, Jacobsen Teixeira M. The WHO analgesic ladder for cancer pain control, twenty years of use. How much pain relief does one get from using it?. Support Care Cancer. 2006;14:1086–1093
  33. Fainsinger RL, Nekolaichuk CL, Lawlor PG, et al. A multi-center study of the revised Edmonton Staging System for classifying cancer pain in advanced cancer patients. J Pain Symptom Manage. 2005;29:224–237
  34. Portenoy RK, Hagen NA. Breakthrough pain: definition, prevalence and characteristics. Pain. 1990;41:273–281
  35. Teunissen SC, Wesker W, Kruitwagen C, et al. Symptom prevalence in patients with incurable cancer: a systematic review. J Pain Symptom Manage. 2007;34:94–104
  36. Del Fabbro E, Dalal S, Bruera E. Symptom control in palliative care—Part II: cachexia/anorexia and fatigue. J Palliat Med. 2006;9:409–421
  37. Vainio A, Auvinen A. Prevalence of symptoms among patients with advanced cancer: an international collaborative study. J Pain Symptom Manage. 1996;12:3–10
  38. Laugsand EA, Kaasa S, de Conno F, Hanks G, Klepstad P. Intensity and treatment of symptoms in 3,030 palliative care patients: a cross-sectional survey of the EAPC Research Network. J Opioid Manag. 2009;5:11–21
  39. Klaschik E, Nauck F, Ostgathe C. Constipation—modern laxative therapy. Support Care Cancer. 2003;11:679–685
  40. Thomas J, Karver S, Cooney GA, et al. Methylnaltrexone for opioid-induced constipation in advanced illness. N Engl J Med. 2008;358:2332–2343
  41. Reddy SK, Parsons HA, Elsayem A, Palmer JL, Bruera E. Characteristics and correlates of dyspnea in patients with advanced cancer. J Palliat Med. 2009;12:29–36
  42. Ben-Aharon I, Gafter-Gvili A, Paul M, Leibovici L, Stemmer SM. Interventions for alleviating cancer-related dyspnea: a systematic review. J Clin Oncol. 2008;26:2396–2404
  43. Matsuo N, Morita T. Efficacy, safety, and cost effectiveness of intravenous midazolam and flunitrazepam for primary insomnia in terminally ill patients with cancer: a retrospective multicenter audit study. J Palliat Med. 2007;10:1054–1062
  44. Mystakidou K, Tsilika E, Parpa E, et al. Assessment of anxiety and depression in advanced cancer patients and their relationship with quality of life. Qual Life Res. 2005;14:1825–1833

PII: S0885-3924(10)00500-2

doi: 10.1016/j.jpainsymman.2010.02.026

Journal of Pain and Symptom Management
Volume 40, Issue 5 , Pages 652-660 , November 2010

Article Tools

* Image Usage & Resolution