Early specialized palliative care for patients with metastatic lung cancer receiving chemotherapy: A feasibility study of a nurse-led screening-triggered programme

Yoshihisa Matsumoto, Shigeki Umemura, Ayumi Okizaki, Daisuke Fujisawa, Naoko Kobayashi, Yuko Tanaka, Chiyuki Sasaki, Ken Shimizu, Asao Ogawa, Hiroya Kinoshita, Yosuke Uchitomi, Kazuhiro Yoshiuchi, Yutaka Matsuyama, Tatsuya Morita, Koichi Goto, Yuichiro Ohe

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Strategies to implement early specialized palliative care have not yet been established. The present study investigated the feasibility of a nurse-led, screening-triggered early specialized palliative care intervention programme and obtained data to design a randomized controlled trial. Methods: Patients with metastatic lung cancer undergoing first-line platinum-based chemotherapy were eligible. The intervention consisted of (1) a questionnaire-based screening programme and (2) advanced-level nurse counselling and care coordination with interdisciplinary team approach. The primary endpoint was the completion rate of the assessment questionnaire after the second course of first-line chemotherapy (T2). Secondary endpoints included changes in Functional Assessment of Cancer Therapy-Lung scores, depression and anxiety rates based on the Patient Health Questionnaire 9 and the Hospital Anxiety and Depression Scale, and the contents of specialized palliative care. Results: A total of 50 patients were enrolled between August 2012 and March 2014. Median age was 66 years (range, 40-78 year) and 84% were male. A total of 38 patients had stage IV non-small cell lung carcinoma and 12 had extensive disease small-cell lung carcinoma. The completion rate was 70% (95% confidence interval 56.0-81.0). The median duration between baseline and T2 was 53 days. Improvement from baseline were observed at T2 in Functional Assessment of Cancer Therapy-Lung scores (86.0 ± 18.1 vs 94.9 ± 18.2, P = 0.057), depression (16.0 vs 5.7%; P = 0.26) and anxiety (32.0 vs 22.9%; P = 0.65); however, these results were not statistically significant. Conclusions: This early specialized palliative care intervention is feasible and could be useful in improving patients' quality of life. The present results justify the initiation of a randomized control trial.

Original languageEnglish
Pages (from-to)375-382
Number of pages8
JournalJapanese journal of clinical oncology
Volume52
Issue number4
DOIs
Publication statusPublished - 2022 Apr 1

Keywords

  • Feasibility study
  • lung cancer
  • palliative care
  • quality of life

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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