A study looking at improving quality of life for people with mesothelioma of the chest (RESPECT-Meso)

The study team found that referring people early to a specialist palliative care team didn't improve peoples quality of life and wellbeing. This was particulalry so if there was good access to a palliative care team where the person was receiving treatment. 

About this study
This was a randomised study. Everyone was put into 1 of 2 groups. Neither they nor their doctor chose which group they were in. 

174 people joined the study.

87 people saw a specialist palliative care team:

• within 3 weeks of being randomised
• then every 4 weeks up to 24 weeks

This was the intervention group.

87 people were referred to a specialist palliative care team when needed. This was the control group. 

Everyone filled in quality of life questionnaires every 4 weeks up to 24 weeks. 

145 main carers also joined the study: 

• 73 carers of people in the intervention group
• 72 carers of people in the control group

They filled in a few questionnaires when they joined the study and 12 weeks later. The questions were about their:

• general health
• mood
• satisfaction of the end of life care for their loved one

Results 
Of the 87 people in the intervention group, 84 (96.6%) visited the specialist palliative care team at least once before the 12 weeks. 68 people (78.2%) completed all 3 visits.

Of the 87 people in the control group, 15 people (17.2%) were referred and seen by the specialist palliative care team at 12 weeks. By the end of the study 30 people (34.5%) in this group were referred and seen by the specialist palliative care team. The study was for 24 weeks.

At 12 weeks after randomisation the study team looked at the difference in the quality of life between the 2 groups. They found there was no significance between the groups. 

During the 24 weeks 30 people died. When the team compared the number of deaths in each group they found there was no difference. 

Carers
The team found no significant difference between the physical and mental wellbeing of the 2 groups. 

Carers of those who saw the specialist palliative care team (the control group) were more satisfied with the care their loved one received.   

Conclusion
The study team concluded that these results didn’t support routine early referral to a specialist palliative care team for people: 

• who were newly diagnosed and
• whose performance status (general health) is good 

This was if they are followed up by a specialist team and can get access to a specialist palliative care team if they need to. 

They say that the current practice of referring to a specialist palliative care team based on the person’s symptoms and their doctor’s judgement should continue. 

The increase of satisfaction of carers who saw a specialist palliative care team is interesting. But the team thought this finding alone wasn’t enough to change practice. 

Where this information comes from    
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed ) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.