Early integration of oncology and palliative care (EIPC) improves approach-oriented coping among patients with incurable cancer, leading to improvements in quality of life (QoL), according to a study published in the Journal of Clinical Oncology.1
For this non-blinded study, researchers assessed the outcomes of 350 patients with newly diagnosed and incurable gastrointestinal or lung cancer who were randomly assigned to EIPC with oncology care or oncology care alone.
The Functional Assessment of Cancer Therapy-General (FACT-G) was used to evaluate quality of life, the Patient Health Questionnaire-9 (PHQ-9) was used to evaluate depression, and subscales of the Brief COPE were used to measure patients’ use of coping strategies. Patients completed both questionnaires at baseline and after 24 weeks.
Patient use of EIPC significantly improved approach-oriented coping strategies (B = 1.09; SE = 0.44; P = .01), and avoidant strategies (B = -0.44; SE = 0.23; P = .06) from baseline to 24 weeks compared with oncology care alone. The improvement of these 2 coping strategies was associated with improved QoL and reduced depressive symptoms at 24 weeks.
Improvements in approach-oriented coping — but not avoidant coping — significantly affected the effects of EIPC on QoL (indirect effect, 1.27; 95% CI, 0.33-2.86) and depressive symptoms (indirect effect, -0.39; 95% CI, -0.87 to -0.08).
The authors concluded that “this study provides evidence suggesting that [palliative care] clinicians help improve QoL and mood outcomes in patients with incurable cancer in part by enhancing effective coping processes.”
- Greer JA, Jacobs JM, El-Jawahri A, et al. Role of patient coping strategies in understanding the effects of early palliative care on quality of life and mood. J Clin Oncol. 2017 Nov 15. doi: 10.1200/JCO.2017.73.7221 [Epub ahead of print]