[Show abstract][Hide abstract] ABSTRACT: Advanced cancer patients experience considerable symptoms, problems, and needs. Early referral of these patients to specialized palliative care (SPC) could offer improvements. The Danish Palliative Care Trial (DanPaCT) investigates whether patients with metastatic cancer will benefit from being referred to 'early SPC'. DanPaCT is a multicenter, parallel-group, superiority clinical trial with 1:1 randomization. The planned sample size was 300 patients. The primary data collection for DanPaCT is finished. To prevent outcome reporting bias, selective reporting, and data-driven results, we present a detailed statistical analysis plan (SAP) for DanPaCT here.
[Show abstract][Hide abstract] ABSTRACT: Advanced cancer patients experience considerable symptoms, problems, and needs. Early referral of these patients to specialised palliative care (SPC) could improve their symptoms and problems.The Danish Palliative Care Trial (DanPaCT) investigates whether patients with metastatic cancer, who report palliative needs in a screening, will benefit from being referred to 'early SPC'.
DanPaCT is a clinical, multicentre, parallel-group superiority trial with balanced randomisation (1:1).The planned sample size is 300 patients. Patients are randomised to specialised palliative care (SPC) plus standard treatment versus standard treatment. Consecutive patients from oncology departments are screened for palliative needs with a questionnaire if they: a) have metastatic cancer; b) are 18 years or above; and c) have no prior contact with SPC. Patients with palliative needs (i.e. symptoms/problems exceeding a certain threshold) according to the questionnaire are eligible. The primary outcome is the change in the patients' primary need (the most severe symptom/problem measured with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)). Secondary outcomes are other symptoms/problems (EORTC QLQ-C30), satisfaction with health care (FAMCARE P-16), anxiety and depression (the Hospital Anxiety and Depression scale), survival, and health care costs.
Only few trials have investigated the effects of SPC. To our knowledge DanPaCT is the first trial to investigate screening based 'early SPC' for patients with a broad spectrum of cancer diagnosis.Trial registration: Current controlled Trials NCT 01348048.
BMC Palliative Care 10/2013; 12(1):37. · 1.12 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Palliative medicine is the medical part of total palliative care and has been a specialty of its own in United Kingdom since 1987. The development of palliative care has been slower in Denmark. The Danish Medical Association for Palliative Medicine was founded in 2001 and in 2003 initiated a theoretical specialist course in palliative medicine with participants from the 5 Nordic countries. Hospices and specialist palliative teams have been established but there is a great need for development of palliative care in hospitals and in the primary care, and a huge need for education and training of professionals, including doctors.
[Show abstract][Hide abstract] ABSTRACT: The development of palliative care started in England where St. Christopher's Hospice opened in 1967. In 1990 palliative care was defined by WHO for the first time. In Denmark development has been retarded and palliative care has not been given high priority by the national health authorities. The first hospice in Denmark opened in 1992, and national guidelines were published in 1999. However, the intentions of the guidelines have not been followed systematically. This article describes the development in Denmark and outlines perspectives on possible future directions.