Palliative care is not likely to reduce psychological distress among patients, recent research has found.
Researchers found no statistically significant improvements in patient or caregiver anxiety, depression or psychological distress in a randomized trial or palliative care interventions, according to a study published in the Journal of Pain and Symptom Management.
“We also found that over a third of randomized clinical trials included in our study excluded people with existing mental health conditions,” lead author Molly Nowels, a doctorate student at Rutgers University, said in a statement. “This means that some of the people who might be most in need of palliative care’s integrative approach to suffering are not being represented in clinical trials, which could perpetuate inequalities for people with mental health conditions.”
This study examined results from 38 previously published studies and combined them to examine the average effect of the interventions on psychological distress.
Though palliative providers offer psychosocial support to patients and families, this approach is less effective than evidence-based therapeutic interventions such as cognitive behavioral therapy, the study indicated.
One contributing factor may be the wide variation in the professional backgrounds of interdisciplinary team members, as well as the specific therapies for addressing psychological distress, the study indicated. Also, many palliative care providers have not kept up to date with advancements in managing psychological distress.
The researchers uncovered no evidence to support the idea that palliative care interventions reduce psychological distress but did identify conceptual and methodological problems in the literature that could be remedied, such as including patients with existing mental health conditions in studies and increasing transparency and accountability through pretrial registration.
More work is needed to adapt and integrate evidence-based psychological interventions into studies of palliative care and evaluate outcomes in seriously ill populations, the researchers recommended.
“We believe that researchers must include patients with existing mental health conditions in future palliative care intervention studies to improve the quality of care for this group,” Nowels said.