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Impact of Palliative Care in Evaluating and Relieving Symptoms in Patients with Advanced Cancer. Results from the DEMETRA Study

Author

Listed:
  • Oscar Corli

    (Department of Oncology, Unit of Pain and Palliative Care Research, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy)

  • Giacomo Pellegrini

    (Fondazione Floriani, Via Privata Nino Bonnet, 2-20154 Milan, Italy)

  • Cristina Bosetti

    (Department of Oncology, Laboratory of Methodology for Clinical Research, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156, Milan, Italy)

  • Luca Riva

    (Dipartimento Fragilità/Rete Locale Cure palliative, ASST Lecco, 23900 Lecco, Italy)

  • Matteo Crippa

    (Fondazione Floriani, Via Privata Nino Bonnet, 2-20154 Milan, Italy)

  • Emanuele Amodio

    (Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy)

  • Gianlorenzo Scaccabarozzi

    (Dipartimento Fragilità/Rete Locale Cure palliative, ASST Lecco, 23900 Lecco, Italy)

Abstract

Background: Cancer patients experience multiple symptoms throughout the course of the disease. We aimed to provide a comprehensive analysis of the symptom burden in patients with advanced cancer at admission to specialist palliative care (PC) services and seven days later to estimate the immediate impact of PC intervention. Patient and methods: The analysis was based on an observational, prospective, multicenter study (named DEMETRA) conducted in Italy on new patients accessing network specialist PC centers during the period May 2017–November 2017. The prevalence and intensity of symptoms were assessed at baseline and after seven days using three tools including the Edmonton Symptom Assessment System (ESAS). Results: Five PC centers recruited 865 cancer patients. Thirty-three different symptoms were observed at the baseline, the most frequent being asthenia (84.9%) and poor well-being (71%). The intensity of the most frequent symptoms according to ESAS ranged from 5.5 for asthenia to 3.9 for nausea. The presence and intensity of physical symptoms increased with increasing levels of anxiety and depression. After seven days, prevalence of nausea and breathlessness as well as intensity of almost all symptoms significantly decreased. Conclusions: The study confirmed the considerable symptom burden of patients with advanced cancer. PC intervention has significantly reduced the severity of symptoms, despite the patients’ advanced disease and short survival.

Suggested Citation

  • Oscar Corli & Giacomo Pellegrini & Cristina Bosetti & Luca Riva & Matteo Crippa & Emanuele Amodio & Gianlorenzo Scaccabarozzi, 2020. "Impact of Palliative Care in Evaluating and Relieving Symptoms in Patients with Advanced Cancer. Results from the DEMETRA Study," IJERPH, MDPI, vol. 17(22), pages 1-11, November.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:22:p:8429-:d:444939
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    Cited by:

    1. Zahra Mojtahedi & Ji Won Yoo & Karen Callahan & Neeraj Bhandari & Donghui Lou & Katayoon Ghodsi & Jay J. Shen, 2021. "Inpatient Palliative Care Is Less Utilized in Rare, Fatal Extrahepatic Cholangiocarcinoma: A Ten-Year National Perspective," IJERPH, MDPI, vol. 18(19), pages 1-10, September.

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