Zhongguo quanke yixue (Oct 2023)

Efficacy of Community-involved Hospice Care for Patients with Advanced Cancer: a Meta-analysis

  • HU Jingyi, HONG Jing, GUO Xiaodong, ZHANG Xiaohong, MO Ning, ZHOU Xiaocui, YU Qin, ZHOU Minhua, SUN Yan, NI Liu, SHI Xiaoli, SU Xiaoqing, LI Yuqian

DOI
https://doi.org/10.12114/j.issn.1007-9572.2022.0678
Journal volume & issue
Vol. 26, no. 28
pp. 3573 – 3584

Abstract

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Background Community-based intervention is an important part of palliative care for advanced cancer patients. However, its role in the health management of advanced cancer patients remains to be supported by medical evidence. Objective To evaluate the efficacy of community-involved hospice care for patients with advanced cancer. Methods Wanfang Data Knowledge Service Platform, CNKI, VIP were searched by using Chinese keywords such as "community" "medical model" and "advanced cancer", Cochrane Library, PubMed and Web of Science were searched by using English keywords such as "Community-based" "Model of Palliative Care" "Advanced Cancer" "Quality of Life", to obtain randomized controlled trials (RCTs) related to the efficacy of community-involved hospice care from 2007-01-01 to 2022-05-10 by using Cochrane system evaluation method on 2022-05-22. The quality of RCTs meeting the inclusion criteria was evaluated, and the valid information was extracted for meta-analysis. Results A total of 11 RCTs in English and 9 RCTs in Chinese were included in the study, involving 2 356 and 1 238 patients, respectively. Meta-analysis showed that compared with routine cancer care, community-involved hospice care could improve quality of life and symptom severity in patients with advanced cancer, demonstrated by increasing Functional Assessment of Chronic Illness Therapy-Palliative Care scale socre〔MD (95%CI) =3.77 (0.83, 6.71) , P=0.01〕and Quality of Life Instruments for Cancer Patients scale total score〔MD (95%CI) =12.53 (2.36, 22.69) , P=0.02〕, reducing Functional Assessment of Cancer Therapy scale total score〔MD (95%CI) =-2.61 (-3.53, -1.70) , P<0.01〕 and Edmonton Symptom Assessment System score〔MD (95%CI) =-2.45 (-4.70, -0.20) , P=0.03〕. However, the improvement of community-involved hospice care on depressive symptoms and overall survival rates of patients remains controversial, and its effect on economic indicators such as admission rates, hospitalization days/numbers needs to be further explored. Conclusion Community-involved hospice care can improve the quality of life and symptom severity of patients with advanced cancer, however, its improvement in hospice care in the depressive symptoms and overall survival rates of the patients remains controversial, and its improvement in economic indicators such as admission rate and hospital stay/inpatients admissions remains to be further explored.

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