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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Systematic fast-track transition from oncological treatment to dyadic specialized palliative home care: DOMUS - a randomized clinical trial

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DOI

  1. Early specialised palliative care: interventions, symptoms, problems

    Research output: Contribution to journalJournal articleResearchpeer-review

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  3. Risk of depression after diagnostic prostate cancer workup - A nationwide, registry-based study

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  4. Is the health literacy of informal caregivers associated with the psychological outcomes of breast cancer survivors?

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BACKGROUND:: The focus of specialized palliative care is to improve quality of life for patients with incurable cancer and their relatives including an increased opportunity to make their own choice of place of care and death.

AIM:: To investigate whether a systematic fast-track transition from oncological treatment to specialized palliative care at home for patients with incurable cancer reinforced with a psychological dyadic intervention could result in more time spent at home and death at home. Secondary aims were to investigate effects on quality of life, symptomatology and survival.

DESIGN:: A prospective, single-centre, randomized controlled trial ( Clinicaltrials.gov : NCT01885637).

SETTING/PARTICIPANTS:: In all, 340 patients with incurable cancer and no or limited antineoplastic treatment options.

RESULTS:: No statistically significant difference was found regarding number of deaths (4%, p = 0.460) and time spent at home (3%, p = 0.491). The secondary outcomes indicated that the intervention resulted in improved quality of life (-11.6 ± 25.5, p = 0.005, effect size = -0.44, 95% confidence interval = -0.77; -0.11), social functioning (-15.8 ± 31.4, p = 0.001, effect size = -0.50, 95% confidence interval = -0.84; -0.17) and emotional functioning (-9.1 ± 21.2, p = 0.039, effect size = -0.43, 95% confidence interval = -0.76; -0.10) after 6 months. A linear mixed-effect regression model confirmed a possible effect on emotional and social functioning at 6 months. Regarding survival, no differences were found between groups ( p = 0.605). No adverse effects were seen as consequence of the intervention.

CONCLUSIONS:: The main findings indicated that the intervention had no effect on time spent at home or place of death. However, the intervention resulted in a weak improvement of quality of life, social functioning and emotional functioning after 6 months.

Original languageEnglish
JournalPalliative Medicine
Volume33
Issue number2
Pages (from-to)135-149
Number of pages15
ISSN0269-2163
DOIs
Publication statusPublished - 2019

    Research areas

  • Cancer, home care services, palliative care, psychological intervention, quality of life, randomized controlled trial, Transitional Care/standards, Palliative Care/standards, Hospice and Palliative Care Nursing/standards, Humans, Middle Aged, Male, Oncology Nursing/standards, Home Care Services/standards, Aged, 80 and over, Quality of Life, Female, Aged, Practice Guidelines as Topic

ID: 55863922