Outcomes of Specialty Palliative Care Interventions for Patients With Hematologic Malignancies: A Systematic Review

Abstract

Context: The outcomes of specialty palliative care (PC) interventions for patients with hematologic malignancies (HMs) is under-investigated.

Objectives: We performed a systematic review to evaluate the effect of PC interventions on patient- and caregiver- reported outcomes and healthcare utilization among adults with HMs (leukemia, myeloma, and lymphoma).

Methods: From database inception through September 10, 2020, we systematically searched PubMed, CINAHL, Embase, Scopus, Web of Science, and Cochrane Reviews using terms representing HMs and PC. Eligible studies investigated adults aged 18 years and older, were published in the English language, and contained original, quantitative, or qualitative data related to patient- and/or caregiver-centered outcomes and healthcare utilization.

Results: We screened 5345 studies;16 met inclusion criteria and found that specialty PC led to improved symptom management, decreased likelihood of inpatient death, decreased healthcare utilization, decreased cost of healthcare, and improved caregiver-reported outcomes. Patients with HM have a high need for PC which, though increasing over time, is often provided late in the clinical disease course.

Conclusions: Specialty PC interventions improve healthcare outcomes for patients with HMs and should be implemented early and often. There remains a need for additional studies investigating PC use exclusively in patients with HMs.

Keywords: Palliative care; caregiver-reported outcomes; healthcare Utilization; hematology; leukemia; lymphoma; myeloma; patient-reported outcomes; place of death; symptom management.