{"title":"Palliative care utilisation globally by cancer patients: systematic review and meta-analysis.","authors":"Addisu Getie, Gizachew Yilak, Temesgen Ayenew, Baye Tsegaye Amlak","doi":"10.1136/spcare-2024-005000","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The rising global prevalence of cancer reveals significant regional disparities in palliative care adoption. While some countries have incorporated palliative care into their systems, over half of the world lacks such services, and oncology-specific palliative care integration is sparse. This study evaluates the global prevalence of palliative care use among cancer patients.</p><p><strong>Methods: </strong>A comprehensive search across multiple databases was conducted to identify relevant studies. Data extraction and organisation were managed using Microsoft Excel, and analysis was performed with STATA/MP 17.0. A weighted inverse variance random-effects model was applied, and heterogeneity was assessed with Cochrane I² statistics. Subgroup analyses, sensitivity analyses and Egger's test were used to explore heterogeneity, publication bias and influential studies.</p><p><strong>Results: </strong>The global prevalence of palliative care among cancer patients was 34.43% (95% CI: 26.60 to 42.25). Africa had the highest utilisation rate at 55.72% (95% CI: 35.45 to 75.99), while the USA had the lowest at 30.34% (95% CI: 19.83 to 40.86). Studies with sample sizes under 1000 showed a higher utilisation rate of 47.51% (95% CI: 36.69 to 58.32). Approximately 55% (95% CI: 35.26 to 74.80) of patients had a positive attitude towards palliative care, and 57.54% (95% CI: 46.09 to 69.00) were satisfied with the services. Positive attitudes were significantly associated with higher palliative care utilisation.</p><p><strong>Conclusion: </strong>Only about one-third of cancer patients globally receive palliative care, with the highest utilisation in Africa. Nearly half of patients have a favourable attitude towards palliative care, and a similar proportion are satisfied with the services.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Supportive & Palliative Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/spcare-2024-005000","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: The rising global prevalence of cancer reveals significant regional disparities in palliative care adoption. While some countries have incorporated palliative care into their systems, over half of the world lacks such services, and oncology-specific palliative care integration is sparse. This study evaluates the global prevalence of palliative care use among cancer patients.
Methods: A comprehensive search across multiple databases was conducted to identify relevant studies. Data extraction and organisation were managed using Microsoft Excel, and analysis was performed with STATA/MP 17.0. A weighted inverse variance random-effects model was applied, and heterogeneity was assessed with Cochrane I² statistics. Subgroup analyses, sensitivity analyses and Egger's test were used to explore heterogeneity, publication bias and influential studies.
Results: The global prevalence of palliative care among cancer patients was 34.43% (95% CI: 26.60 to 42.25). Africa had the highest utilisation rate at 55.72% (95% CI: 35.45 to 75.99), while the USA had the lowest at 30.34% (95% CI: 19.83 to 40.86). Studies with sample sizes under 1000 showed a higher utilisation rate of 47.51% (95% CI: 36.69 to 58.32). Approximately 55% (95% CI: 35.26 to 74.80) of patients had a positive attitude towards palliative care, and 57.54% (95% CI: 46.09 to 69.00) were satisfied with the services. Positive attitudes were significantly associated with higher palliative care utilisation.
Conclusion: Only about one-third of cancer patients globally receive palliative care, with the highest utilisation in Africa. Nearly half of patients have a favourable attitude towards palliative care, and a similar proportion are satisfied with the services.
期刊介绍:
Published quarterly in print and continuously online, BMJ Supportive & Palliative Care aims to connect many disciplines and specialties throughout the world by providing high quality, clinically relevant research, reviews, comment, information and news of international importance.
We hold an inclusive view of supportive and palliative care research and we are able to call on expertise to critique the whole range of methodologies within the subject, including those working in transitional research, clinical trials, epidemiology, behavioural sciences, ethics and health service research. Articles with relevance to clinical practice and clinical service development will be considered for publication.
In an international context, many different categories of clinician and healthcare workers do clinical work associated with palliative medicine, specialist or generalist palliative care, supportive care, psychosocial-oncology and end of life care. We wish to engage many specialties, not only those traditionally associated with supportive and palliative care. We hope to extend the readership to doctors, nurses, other healthcare workers and researchers in medical and surgical specialties, including but not limited to cardiology, gastroenterology, geriatrics, neurology, oncology, paediatrics, primary care, psychiatry, psychology, renal medicine, respiratory medicine.