November 21, 2016

Palliative care was associated with statistically and clinically significant improvements in measures of patient quality of life and symptom burden at the one- to three-month follow-up; however, no association was found between palliative care and survival.

Those are the results of a study, “Association Between Palliative Care and Patient and Caregiver Outcomes: A Systematic Review and Meta-analysis,” published in the Nov. 22/29 issue of JAMA. The study was led by Dio Kavalieratos, PhD, adjunct professor in UNC’s Gillings School of Global Public Health’s Department of Health Policy and Management.

Kavalieratos and his co-authors examined the association of palliative care with quality of life (QOL), symptom burden, survival and other outcomes for people with life-limiting illness and for their caregivers.

Dr. Dio Kavalieratos

Dr. Dio Kavalieratos

Palliative care was associated consistently with improvements in advance care planning, patient and caregiver satisfaction, and lower health care utilization. There was mixed evidence of associations of palliative care with site of death; patient mood; health care expenditures; and caregiver QOL, mood or burden.

“Taken together, there is a very compelling message here that people’s quality of life and symptoms improved, their experiences with their care improved, all during what is likely one of the most difficult periods of their lives,” Kavalieratos says.

Palliative care focuses on improving quality of life (QOL) and reducing suffering for seriously ill patients and their families. More than 65 percent of U.S. hospitals have an inpatient palliative care program. To provide an up-to-date summary of palliative care outcomes, the authors identified 43 randomized clinical trials of palliative care interventions in adults with life-limiting illness for a systematic review and meta-analyses. The trials provided data on 12,731 patients (average age, 67 years) and 2,479 caregivers. Thirty-five trials used usual care as the control, and 14 took place in the ambulatory setting.

While Kavalieratos said the findings are encouraging, he hopes more research can be done soon.

“We need to better understand the underlying mechanisms by which palliative care creates the benefits we’ve seen, as well as to help us understand under what conditions does palliative care create the biggest benefits for patients and their families,” Kavalieratos says. “We also need to find ways of integrating palliative care concepts in patients’ usual care experiences, so that palliative care isn’t a luxury, but a standard part of health care for those of us living with serious illness.”


Gillings School of Global Public Health contact: David Pesci, director of communications, (919) 962-2600 or

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