The imPaCT study: a randomised controlled trial to evaluate a hospital palliative care team.
A randomised controlled trial was undertaken to assess the effectiveness of a hospital Palliative Care Team (PCT) on physical symptoms and health-related quality of life (HRQoL); patient, family carer and primary care professional reported satisfaction with care; and health service resource use. The full package of advice and support provided by a multidisciplinary specialist PCT ('full-PCT') was compared with limited telephone advice ('telephone-PCT', the control group) in the setting of a teaching hospital trust in the SW of England. The trial recruited 261 out of 684 new inpatient referrals; 175 were allocated to 'full-PCT', 86 to 'telephone-PCT' (2 : 1 randomisation); with 191 (73%) being assessed at 1 week. There were highly significant improvements in symptoms, HRQoL, mood and 'emotional bother' in 'full-PCT' at 1 week, maintained over the 4-week follow-up. A smaller effect was seen in 'telephone-PCT'; there were no significant differences between the groups. Satisfaction with care in both groups was high and there was no significant difference between them. These data reflect a high standard of care of patients dying of cancer and other chronic diseases in an acute hospital environment, but do not demonstrate a difference between the two models of service delivery of specialist palliative care.
Hanks
G W
GW
Unit of Palliative Medicine, Division of Oncology, University of Bristol, Bristol Haematology and Oncology Centre, Horfield Road, Bristol BS2 8ED, UK. Debbie.ashby@bristol.ac.uk
Robbins
M
M
Sharp
D
D
Forbes
K
K
Done
K
K
Peters
T J
TJ
Morgan
H
H
Sykes
J
J
Baxter
K
K
Corfe
F
F
Bidgood
C
C
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004739:England; D005260:Female; D018575:Home Care Services, Hospital-Based / Q000592:standards; D017051:Hospice Care / Q000379:methods / Q000592:standards; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods* / Q000592:standards; D010348:Patient Care Team / Q000592:standards*; D011788:Quality of Life; D013727:Terminal Care / Q000379:methods* / Q000523:psychology / Q000592:standards; D013997:Time Factors