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Master Thesis

Les indicateurs de « soins agressifs du cancer en fin de vie » et leur association avec la prise en charge palliative : revue systématique de littérature

Abstract : Objective: indicators of “aggressiveness of cancer care near the end of life” published by Earle et al are widely studied as they can represent poor quality of care. This study aimed to systematically review the literature to determine whether specialized palliative care interventions is associated with the reduction of these indicators. Materials and methods: according to PRISMA-R statement, we performed a systematic review of randomised and non randomised control trials (RCTs) and observational studies, in MEDLINE and Web of Science databases from 2003 to 2019. According to the eligible criterion, independent reviewers selected articles evaluating the association between palliative care intervention and indicators of agressiveness of cancer care near the end-of life. A qualitative and synthesis analysis was made. Results: from 976 references, we reviewed 38 studies including 4 RTCs, 2 prospective non randomised studies and 31 observational studies. We selected 14 studies of adequate quality for the main results table. Among those study, there are evidences that specialized palliative care particularly early and outpatient palliative care is associated with reduction of aggressiveness of cancer care near the end of life. Conclusion: heterogeneities in methodologies, disparities between palliative care interventions and multiples bias particularly in observational studies make generalization difficult. Improving quality and measuring factors that can contribute to reduce agressiveness of cancer care near end of life seems necessary. Integrated palliative care throughout the disease trajectory are ways to improve quality of end-of-life care.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02517115
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Tuesday, March 24, 2020 - 12:25:41 PM
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Juline Auclair. Les indicateurs de « soins agressifs du cancer en fin de vie » et leur association avec la prise en charge palliative : revue systématique de littérature. Médecine humaine et pathologie. 2019. ⟨dumas-02517115⟩

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