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Studying the Effectiveness of Palliative Care
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To the Editor: In their systematic review of specialized palliative care, Dr Zimmerman and colleagues1 defined this as "a service of professionals that provides or coordinates comprehensive care for patients with a terminal illness." Systematic reviews are better at answering very specific questions than very general questions of an exploratory nature. The authors' unfocused definition allowed them to include studies of interventions such as a monthly telephone or oncology nurse outpatient follow-up visit, a coping intervention for caregivers, or a multidisciplinary palliative care team. I believe that because no palliative care expertise was required, their use of the term specialized palliative care is misleading.
The setting in which these interventions took place included patient homes, outpatient clinics, nursing homes, teaching hospitals, and cancer centers. The population included patients with cancer, congestive heart failure, chronic obstructive pulmonary disease, motor neuron disease, AIDS, and dementia. Among the control groups, in 1 study . . . [Full Text of this Article]
Eduardo Bruera, MD
ebruera@mdanderson.org
Department of Palliative Care and Rehabilitation Medicine
University of Texas M. D. Anderson Cancer Center
Houston
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