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Define: verb (used with object), palliated, palliating. to relieve or lessen without curing; mitigate; alleviate.
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JAMA Network | JAMA Oncology | Prospective, Interdisciplinary Randomized Clinical Trials for Patients With Cancer in the Emergency Department: A Step Forward for Palliative Oncology Care
Editor's Note | May 2016
It
is clear that the emergency department (ED) is a source of care for a
considerable portion of the population, including patients experiencing
acute and subacute effects of the underlying malignant disease or
perhaps adverse effects of treatment.1
For those with advanced disease and/or symptoms requiring prompt
palliation, it would seem intuitive to begin formal palliative care in
the ED. In fact, ED practitioners offer end-of-life care management.2
Grudzen and colleagues3
from Mt Sinai and New York University are to be congratulated on their
attempt to address this question in a prospective, randomized clinical
trial.4
The investigators did show an improvement in quality of life as
measured by the Functional Assessment of Cancer Therapy–General Measures
(FACT-G) score at 3 months, in those patients randomized for immediate
palliative care team consultation while they were in the ED. There was a
trend in survival. It would be important to know whether ED initiation
of the palliative care chain will result in a decrease in readmission
rates and the ethnic/racial and socioeconomic disparity of these
services rendered. Future prospective interdisciplinary studies
involving the intersection of emergency and/or urgent care, oncology,
and palliative care practitioners are necessary to further refine
optimal and cost-effective, patient-centered care for patients with
cancer and caregivers.
Todd
KH, Thomas
CR
Jr, eds. Oncologic Emergency Medicine: Principles and Practice. New York, NY: Springer; 2016.
Lamba
S, Mosenthal
AC. Hospice and palliative medicine: a novel subspecialty of emergency medicine. J Emerg Med. 2012;43(5):849-853.
PubMed | Link to Article
PubMed | Link to Article
Grudzen
CR, Richardson
LD, Johnson
PN,
et al. Emergency department–initiated palliative care in advanced
cancer: a randomized clinical trial [published online January 14,
2016]. JAMA Oncol. doi:10.1001/jamaoncol.2015.5252.
Kandarian
B, Morrison
RS, Richardson
LD, Ortiz
J, Grudzen
CR. Emergency department-initiated palliative care for
advanced cancer patients: protocol for a pilot randomized controlled
trial. Trials. 2014;15:251.
PubMed | Link to Article
PubMed | Link to Article
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