Study: Palliative Care Does Not Reduce Psychological Distress

A Rutgers study found that palliative care, a type of specialized medical care aimed at enhancing the quality of life for those with serious illnesses like cancer or heart failure, is unlikely to lessen psychological discomfort.

In a meta-analysis of 38 randomized clinical trials evaluating palliative care therapies, the study’s authors reported no statistically significant reductions in patient or carer anxiety, depression, or psychological distress. The results were published in the Journal of Pain and Symptom Management. The average impact of the therapies on psychological distress was examined in this study using data from 38 previously published studies.

General psychological support is frequently provided in palliative care, although this strategy is less efficient than evidence-based therapeutic interventions like cognitive behavioral therapy. When it comes to the professional backgrounds of the team members and the application of therapies proven to reduce psychological suffering, palliative care interventions differ greatly.

Clinicians in palliative care frequently see patients and their families who are experiencing psychological distress symptoms such as despair, sorrow, anxiety, negative affect, and dread. As they get closer to the end of their lives, patients with cancer, heart failure, and lung illness typically report worsening depressive symptoms.

Palliative care is intended to help patients and their families who are dealing with serious illnesses identify, analyze, and manage their pain as well as their physical, psychological, social, and spiritual needs. To alleviate psychological distress, palliative care implementation frequently hasn’t fully included developments in psychiatry and psychological science.

Researchers at Rutgers University, under the direction of doctoral student Molly Nowels, used a protocol-based systematic review and meta-analysis to investigate whether palliative care interventions affect psychological distress in any way.

However, they did find conceptual and methodological issues in the literature that could be fixed, such as including patients with pre-existing mental health conditions in studies and enhancing transparency and accountability through pretrial registration. Although the researchers did not find any evidence to support the claim that palliative care interventions reduce psychological distress.

Studies of palliative care and evaluation of outcomes in seriously sick populations both require more work in adapting and integrating evidence-based psychological therapies. that’s what the researchers found.

“We also found that over a third of randomized clinical trials included in our study excluded people with existing mental health conditions,” said Nowels.

“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. 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.”

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