What is the impact of specialist palliative care outpatient consultations on pain in adult patients with cancer? A systematic review

https://doi.org/10.1016/j.ejon.2021.102034Get rights and content
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Highlights

  • Pain control is one key dimension of quality patient care.

  • Specialist Palliative Care (SPC) has the opportunity to control pain.

  • Additional future cost-effectiveness analysis is needed to inform healthcare policy in relation to outpatient SPC.

Abstract

Purpose

The aim of this systematic review was to determine the impact of specialist palliative care (SPC) consultations in outpatient settings on pain control in adults suffering from cancer.

Methods

Systematic Review. Databases CINAHL, Medline, PsychInfo, and Embase were searched in February 2021. Relevant studies were also hand-searched and gray literature was searched in February 2021. The PICO mnemonic (Population, Intervention, Comparison, and Outcome) was used to form the review question. Of 1053 potential studies identified, 10 met the inclusion criteria. Quality appraisal of included studies was conducted using the evidence-based librarian (EBL) critical appraisal checklist.

Results

Outcome data from 56% (n = 5/9) studies indicated a non-statistically significant reduction in pain. Narrative analysis of the remaining studies indicated a statistically significant reduction in pain in 50% (n = 2/4) of the studies, one study showed mixed results, and one study found no statistically significant improvement in pain control. In relation to secondary outcomes, results from 33% (3/9) of studies indicated statistically significant improvement in symptom control. Data from 22% (n = 2/9) of studies indicated no statistically significant improvement in the symptoms measured. Narrative analysis of the remaining four studies indicated generally mixed results. EBL scores of included studies ranged between 50% and 95.23%.

Conclusion

Outpatient SPC consultations may have a positive impact on the control of pain and other distressing symptoms for cancer patients, however, results show mixed effects. Given that it is unclear what it is about outpatient SPC that impacts positively or otherwise on pain and symptom control.

Keywords

Palliative care
Palliative medicine
Supportive care
Outpatient clinics
Outpatient consultations
Outpatient interventions
Pain
Pain management
Symptom control
Cancer patients

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