In men with advanced prostate cancer, what is the evidence that referral to specialist palliative care can assist in supporting a patient’s decision making and treatment planning processes?

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In men with advanced prostate cancer, what is the evidence that referral to specialist palliative care can assist in supporting a patient’s decision making and treatment planning processes?

In relation to the role of specialist palliative care in supporting decision-making and treatment planning processes, there was Level II evidence that a coordinated palliative approach to care can improve quality-of-life measures and enhance satisfaction for men and their carers.[1][2][3][4] Engelhardt described a programme of co-ordinated care of advanced illness in which a significantly increased number of patients completed advance care plans (p=0.006).[3] Supporting patients’ processes of decision-making and care planning is seen as an important aspect of the work of specialist palliative care services. Palliative care services in Australia are often engaged in promoting the use of advance care planning instruments legislated by states and territories and in the appointment of a nominated medical agent.

Palliative care question 1: In men with metastatic prostate cancer what is the evidence that referral to specialist palliative care can assist in supporting a patient’s decision-making and treatment planning processes?

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Evidence summary and recommendations

Evidence summary Level References
There is evidence that the involvement of a specialist palliative care team or a coordinated palliative approach to care can improve satisfaction with care for patients with advanced cancer, as well as increase the frequency with which advance care plans are made. This finding can be generalised to men with metastatic prostate

cancer.

II [1], [2], [3], [4]
Evidence-based recommendationQuestion mark transparent.png Grade
Men with metastatic prostate cancer should be referred for specialist palliative care or a coordinated palliative approach to assist in advance care planning.
C


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References

  1. 1.0 1.1 Moore S, Corner J, Haviland J, Wells M, Salmon E, Normand C, et al. Nurse led follow up and conventional medical follow up in management of patients with lung cancer: randomised trial. BMJ 2002 Nov 16;325(7373):1145 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/12433764.
  2. 2.0 2.1 Kane RL, Wales J, Bernstein L, Leibowitz A, Kaplan S. A randomised controlled trial of hospice care. Lancet 1984 Apr 21;1(8382):890-4 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/6143195.
  3. 3.0 3.1 3.2 Engelhardt JB, McClive-Reed KP, Toseland RW, Smith TL, Larson DG, Tobin DR. Effects of a program for coordinated care of advanced illness on patients, surrogates, and healthcare costs: a randomized trial. Am J Manag Care 2006 Feb;12(2):93-100 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/16464138.
  4. 4.0 4.1 Hughes SL, Cummings J, Weaver F, Manheim L, Braun B, Conrad K. A randomized trial of the cost effectiveness of VA hospital-based home care for the terminally ill. Health Serv Res 1992 Feb;26(6):801-17 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/1737710.

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Appendices