Systematic referral to palliative care in patients attending dedicated emergency units from French comprehensive anticancer centres: the prospective multicentre randomised comparative clinical trial PALLU.

Fiche publication

Date publication

août 2025

Journal

BMJ open

Auteurs

Membres identifiés du Cancéropôle Est :
Dr HENRY Aline

Tous les auteurs :
Chvetzoff G, Anota A, Perrier L, Gautier J, Bouleuc C, Moreau P, Thomaso M, Le Divenah G, Henry A, François M, Massiani MA, Mateus C, Merad M, Bissuel L, Baudry AS, Christophe V, Russias B, Pérol D

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/40850913

Résumé

International medical oncology societies recommended early integration of palliative care to alleviate symptoms, improve quality of life and significantly reduce aggressiveness of care near the end of life, defined as the use of chemotherapy, high rate of hospitalisation/visits to emergency or intensive care unit in the last month of life or death in acute care unit. However, the most appropriate schedule for patient referral is still to be determined. Scores and criteria are debated, with uncontrolled symptoms (pain, dyspnoea, distress, etc) being one of the main indicators. These symptoms are also the leading causes for patients with cancer to seek care in emergency units. Several studies in North America suggested that referral to palliative care from emergency units is feasible and efficient.The aim of this study is to determine if systematic early referral to palliative care in a context of emergency reduces aggressiveness of care near the end of life compared with referral on medical team request.