title: Early Palliative Care in Advanced Oncologic and Non-Oncologic Chronic Diseases: A Systematic Review of Literature.
abstract: BACKGROUND
  To assess the role of early palliative care in patients with advanced oncologic and non-oncologic chronic diseases.
  
  
  METHODS
  A qualitative systematic review of literature was performed. All the randomized phase III trials comparing early, simultaneous palliative care and standard care in patients with advanced oncologic and non-oncologic diseases were considered eligible and included into the analysis. The outcomes were classified into 6 classes: quality of life, symptoms control, overall survival, quality of care, patients' and caregivers' satisfaction, and costs of the assistance.
  
  
  RESULTS
  Twelve papers reporting the data of 9 trials were considered eligible and included into the analysis. Two nonrandomized trials were also included into the selection because of the methods used by the authors. The early, simultaneous approach was reported to improve quality of life in two out of 7 papers, symptoms control in 1 out of 5 papers, overall survival in 2 out of 3 papers, quality of care in 5 out of 8 papers, patients' or caregivers' satisfaction in 3 out of 4 papers; and to reduce the costs of assistance in 2 out of 3 papers.
  
  
  CONCLUSIONS
  Early palliative care improves the main outcomes of the assistance in patients with advanced oncologic and non-oncologic chronic diseases. The available data are probably enough to consider early palliative cares a novel standard of care in these groups of patients.
authors.affiliation: Department of Oncology, City Hospital, Rimini, Italy, and Hospice and Palliative Care Unit, City Hospital, Rimini, Italy. dtassinari@rimini.com.
authors.forename: Davide
authors.initials: D
authors.lastname: Tassinari
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Drudi
authors.forename: Maria C
authors.initials: MC
authors.lastname: Monterubbianesi
authors.forename: Lucia
authors.initials: L
authors.lastname: Stocchi
authors.forename: Isabella
authors.initials: I
authors.lastname: Ferioli
authors.forename: Andrea
authors.initials: A
authors.lastname: Marzaloni
authors.forename: Emiliano
authors.initials: E
authors.lastname: Tamburini
authors.forename: Sergio
authors.initials: S
authors.lastname: Sartori
mesh_terms: D002908:Chronic Disease / Q000628:therapy*; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D010166:Palliative Care; D011787:Quality of Health Care