Palliative Care Leads to Improvements in Post-HCT Depression and PTSD

Integrating palliative care with hematopoietic cell transplantation (HCT) can improve depression and post-traumatic stress disorder (PTSD) symptoms at 6 months post-transplant according to a randomized study of 160 transplant recipients.

Researchers randomized autologous and allogeneic transplant patients to brief inpatient palliative care interventions integrated with transplant care (n=81) or transplant care alone (n=79) in this single-center study. They then assessed patients’ mood, PTSD symptoms, and quality of life (QOL) at baseline and 6 months post-transplant.

Patients were assessed using the Hospital Anxiety and Depression Scale and Patient Health Questionnaire, PTSD checklist, and Functional Assessment of Cancer Therapy-Bone Marrow Transplant. To assess symptom burden during HCT, researchers used the Edmonton Symptom Assessment Scale.

At 6 months post-transplant, intervention participants reported lower depression symptoms on the Hospital Anxiety and Depression Scale and Patient Health Questionnaire (adjusted mean difference, -1.21 [95% CI, -2.26 to -0.16; p=0.024] and -1.63 [95% CI, -3.08 to -0.19; p=0.027], respectively) and lower PTSD symptoms (adjusted mean difference, -4.02; 95% CI, -7.18 to -0.86; p=0.013). There were no differences in QOL or anxiety scores.

The study also revealed that reduction in symptom burden and anxiety during HCT partially accounts for the effect of palliative interventions on self-reported levels of depression and PTSD.

The authors conclude that “by addressing patient symptoms during HCT hospitalization, palliative care clinicians may buffer this highly stressful and potentially traumatic experience.”

El-Jawahri A, et al. J Clin Oncol

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