Introducing integrated palliative care to patients with a certain type of leukemia was shown to facilitate active coping strategies, which could improve a patient’s quality of life.
Integrating palliative care during the first series of intensive chemotherapy in patients with acute myeloid leukemia (AML) was associated with an improvement in patients’ coping skills, compared with usual care.
That improvement, according to Dr. Thomas Leblanc, could have a positive effect on a patient’s quality of life, depression and anxiety.
In fact, prior studies have demonstrated the positive impact of integrated palliative care in patients receiving intensive induction chemotherapy.
During the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting, Leblanc, a hematologic oncologist at Duke Cancer Center, presented findings of a study that examined the effect of palliative care on patients’ coping strategies to examine how the approach benefits patients.
“A positive kind of a coping approach would be, for example, positive reframing,” he said in an interview with CURE®. “A negative type of coping would be avoidance and denial. And we know from many years of research in psychology that those kinds of negative coping approaches really are not helpful. They're maladaptive, we would say. So there are ways to actually measure this. And we did that on this trial.”
In this case we did a study in AML, where palliative care has not been integrated before. And that type of a study hadn't been done. Now that we know that there are benefits that we proved in that randomized trial, we were trying here to better understand what might explain the benefits and basically, we said, coping was important in those solid tumor patients. Maybe it's also important in these liquid tumor patients. So that was basically the rationale. And what we looked at specifically with coping is basically the difference between more positive coping styles or coping approaches and more negative sort of maladaptive coping approaches. So a positive kind of a coping approach would be, for example, positive reframing. A negative type of coping would be avoidance and denial. And we know from many years of research in psychology that those kinds of negative coping approaches really are not helpful. They're maladaptive, we would say. So there are ways to actually measure this. And we did that on this trial. We use something called the brief cope questionnaire, it's a patient reported questionnaire. And it allows you to actually categorize the patient's coping styles. And that was a big part of what we looked at in this analysis. And we found that there is significantly more of that positive coping done by the patients who are receiving integrated specialist palliative care and a lot less of that negative coping. And we saw much more of the positive coping as soon as at that two-week time point. And actually, that was sustained to 24 weeks as well.
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