Quality of life in XXXX care: results from a cluster randomized trial.

@entity1 @entity5 @entity158
PURPOSE: To assess the impact of comprehensive palliative care on @entity1 ' quality of life. The intervention was based on cooperation between a palliative medicine unit and the community service and was compared with conventional care. @entity1 AND METHODS: A cluster randomized trial was carried out, with community health care districts defined as the clusters. @entity1 from these districts who had @entity5 and survival expectancy between 2 to 9 months were entered onto the trial. The main quality-of-life end points were physical and emotional functioning, @entity158 , and psychologic distress assessed monthly by using the European Organization for Research and Treatment of @entity5 Quality of Life Questionnaire-C30 (EORTC QLQ-C30) questionnaire and Impact of Event scale (IES). In total, 235 intervention @entity1 and 199 controls were included. RESULTS: During the initial 4 months of follow-up, the compliance was good (72%) and comparable among treatment groups. No significant differences on any of the quality-of-life scores were found. At later assessments and for scores that were made within 3 months before death, there was also no consistent tendency in favor of any treatment group on the main outcomes or other EORTC QLQ-C30 scales/items. CONCLUSION: A general program of palliative care may be important to ensure flexibility and to meet the needs of terminally ill @entity1 . However, to achieve improvements on a group level of the various dimensions of quality of life, specific interventions directed toward specific symptoms or problems may have to be defined, evaluated, and included in the program.
