RT Journal Article SR Electronic T1 Early palliative care and quality of dying and death in patients with advanced cancer JF BMJ Supportive & Palliative Care JO BMJ Support Palliat Care FD British Medical Journal Publishing Group SP bmjspcare-2021-002893 DO 10.1136/bmjspcare-2021-002893 A1 Kenneth Mah A1 Brittany Chow A1 Nadia Swami A1 Ashley Pope A1 Anne Rydall A1 Craig Earle A1 Monika Krzyzanowska A1 Lisa Le A1 Sarah Hales A1 Gary Rodin A1 Breffni Hannon A1 Camilla Zimmermann YR 2021 UL http://spcare.bmj.com/content/early/2021/02/22/bmjspcare-2021-002893.abstract AB Objective Early palliative care (EPC) in the outpatient setting improves quality of life for patients with advanced cancer, but its impact on quality of dying and death (QODD) and on quality of life at the end of life (QOL-EOL) has not been examined. Our study investigated the impact of EPC on patients’ QODD and QOL-EOL and the moderating role of receiving inpatient or home palliative care.Method Bereaved family caregivers who had provided care for patients participating in a cluster-randomised trial of EPC completed a validated QODD scale and indicated whether patients had received additional home palliative care or care in an inpatient palliative care unit (PCU). We examined the effects of EPC, inpatient or home palliative care, and their interactions on the QODD total score and on QOL-EOL (last 7 days of life).Results A total of 157 caregivers participated. Receipt of EPC showed no association with QODD total score. However, when additional palliative care was included in the model, intervention patients demonstrated better QOL-EOL than controls (p=0.02). Further, the intervention by PCU interaction was significant (p=0.02): those receiving both EPC and palliative care in a PCU had better QOL-EOL than those receiving only palliative care in a PCU (mean difference=27.10, p=0.002) or only EPC (mean difference=20.59, p=0.02).Conclusion Although there was no association with QODD, EPC was associated with improved QOL-EOL, particularly for those who also received inpatient care in a PCU. This suggests a long-term benefit from early interdisciplinary palliative care on care throughout the illness.Trial registration number ClinicalTrials.gov Registry (#NCT01248624).