Palliative care's new home: The ER

Terminal cancer patients had better quality of life after receiving pain consultations in the emergency department

Studies have shown that the earlier terminal patients are placed on palliative care, the better they fare. Their hospital stays are shorter and fewer resources are wasted on unnecessary and redundant care measures.

But a new study published in the Journal of the American Medical Association (JAMA) Oncology finds that terminal cancer patients who receive pain management consultations and other palliative measures in the emergency department have a significantly better quality of life than patients who do not. Furthermore, their survival rates are not significantly shorter.

The study tracked 69 terminal cancer patients who received palliative care consultations in the ED and 67 patients who did not. On average, patients who received palliative care beginning in the ED lived 289 days versus the 132 days averaged by patients who received regular, non-palliative care.

"Emergency department-initiated palliative care consultation improved quality of life in patients with advanced cancer and does not seem to shorten survival," said study author Corita Grudzen, M.D., of New York University, in the study announcement.

There were no significant variations between the two groups in the areas of depression, admission to intensive care or discharge to hospice care. 

A 2015 report in the Journal of Palliative Medicine found that while 9 in 10 larger U.S. hospitals (300 beds or more) have implemented palliative care programs, smaller hospitals are far behind. The rise of so-called "right-to-die" laws around the country, however, means that the issue is one that all healthcare institutions and hospitals must grapple with in the years ahead.

To learn more:
- read the study in JAMA Oncology here
- see the study announcement here

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'Right-to-die' laws make palliative care more important than ever