Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

The ALLAN trial: impact of early home-based palliative care on emergency care and hospitalisation in advanced gastrointestinal cancer patients

Bojesson, Anders LU ; Brun, Eva LU ; Eberhard, Jakob LU and Segerlantz, Mikael LU (2026) In British Journal of Cancer p.1-7
Abstract
Background
Patients with advanced gastrointestinal (GI) cancer experience a high symptom burden which frequently necessitates emergency care. Integration of early home-based specialised palliative care (SPC) with tumour-specific treatments may impact emergency healthcare use.

Methods
At the initiation of palliative chemotherapy, patients with advanced GI cancer were randomised to early home-based SPC integrated with tumour-specific treatment, or tumour-specific treatment with SPC referral when needed. The aim was to compare quality of life in the two groups. Here we present secondary outcomes; number of emergency department visits, hospitalisations, days of inpatient care, the time from the last chemotherapy treatment to... (More)
Background
Patients with advanced gastrointestinal (GI) cancer experience a high symptom burden which frequently necessitates emergency care. Integration of early home-based specialised palliative care (SPC) with tumour-specific treatments may impact emergency healthcare use.

Methods
At the initiation of palliative chemotherapy, patients with advanced GI cancer were randomised to early home-based SPC integrated with tumour-specific treatment, or tumour-specific treatment with SPC referral when needed. The aim was to compare quality of life in the two groups. Here we present secondary outcomes; number of emergency department visits, hospitalisations, days of inpatient care, the time from the last chemotherapy treatment to death, and the place of death between the study groups.

Results
A total of 118 patients were randomised. Patients in the early SPC group had significantly fewer emergency department visits (median 1 versus 3), hospitalisations (median 1 versus 2), and inpatient care days (median 1.5 vs. 11.5) compared to the control group (p < 0.001). There was no significant difference between the study groups in either time between the last chemotherapy treatment and death, inpatient SPC or place of death.

Conclusion
Early integration of home-based SPC in advanced GI cancer patients significantly reduces emergency healthcare use and hospitalisation. (Less)
Abstract (Swedish)
Bakgrund: Patienter med avancerad gastrointestinal (GI) cancer har en hög symtombörda, vilket ofta medför behov av akutsjukvård. Integration av tidig, hem-baserad specialiserad palliativ vård (SPV) tillsammans med tumörspecifik behandling kan påverka behov av akut sjukvård.

Metoder: Vid initiering av palliativ kemoterapi randomiserades patienter med avancerad GI-cancer till tidig hem-baserad SPV integrerad med tumörspecifik behandling, eller till tumörspecifik behandling med remiss till SPV vid behov.

Syftet var att jämföra livskvalitet mellan de två grupperna. Här presenterar vi sekundära utfallsmått: antal besök på akutmottagning, antal sjukhusinläggningar, antal vårddygn inom slutenvård, tiden från sista... (More)
Bakgrund: Patienter med avancerad gastrointestinal (GI) cancer har en hög symtombörda, vilket ofta medför behov av akutsjukvård. Integration av tidig, hem-baserad specialiserad palliativ vård (SPV) tillsammans med tumörspecifik behandling kan påverka behov av akut sjukvård.

Metoder: Vid initiering av palliativ kemoterapi randomiserades patienter med avancerad GI-cancer till tidig hem-baserad SPV integrerad med tumörspecifik behandling, eller till tumörspecifik behandling med remiss till SPV vid behov.

Syftet var att jämföra livskvalitet mellan de två grupperna. Här presenterar vi sekundära utfallsmått: antal besök på akutmottagning, antal sjukhusinläggningar, antal vårddygn inom slutenvård, tiden från sista cytostatikabehandling till död samt dödsplats mellan studiegrupperna.

Resultat: Totalt randomiserades 118 patienter. Patienter i gruppen med tidig SPV hade signifikant färre besök på akutmottagning (median 1 jämfört med 3), färre sjukhusinläggningar (median 1 jämfört med 2) samt färre vårddygn i slutenvård (median 1,5 jämfört med 11,5) jämfört med kontrollgruppen (p < 0,001). Det fanns ingen signifikant skillnad mellan grupperna avseende tiden mellan sista kemoterapibehandling och död, slutenvårdsbaserad SPV eller dödsplats.

Slutsats: Tidig integration av hem-baserad specialiserad palliativ vård av patienter med avancerad GI-cancer minskar signifikant behov av akutsjukvård och behovet av sjukhusvård. (Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Palliativ medicin, Palliative cancer care
in
British Journal of Cancer
pages
1 - 7
publisher
Nature Publishing Group
external identifiers
  • pmid:42032200
  • scopus:105036563158
ISSN
1532-1827
DOI
10.1038/s41416-026-03444-8
project
Comprehensive Palliative Care: Person-Centered Treatment for Patients with Advanced Cancer Diseases
language
English
LU publication?
yes
id
6626dc69-8a71-4f03-8a39-febb6253d3e8
date added to LUP
2026-04-30 11:00:53
date last changed
2026-05-01 04:00:36
@article{6626dc69-8a71-4f03-8a39-febb6253d3e8,
  abstract     = {{Background<br/>Patients with advanced gastrointestinal (GI) cancer experience a high symptom burden which frequently necessitates emergency care. Integration of early home-based specialised palliative care (SPC) with tumour-specific treatments may impact emergency healthcare use.<br/><br/>Methods<br/>At the initiation of palliative chemotherapy, patients with advanced GI cancer were randomised to early home-based SPC integrated with tumour-specific treatment, or tumour-specific treatment with SPC referral when needed. The aim was to compare quality of life in the two groups. Here we present secondary outcomes; number of emergency department visits, hospitalisations, days of inpatient care, the time from the last chemotherapy treatment to death, and the place of death between the study groups.<br/><br/>Results<br/>A total of 118 patients were randomised. Patients in the early SPC group had significantly fewer emergency department visits (median 1 versus 3), hospitalisations (median 1 versus 2), and inpatient care days (median 1.5 vs. 11.5) compared to the control group (p &lt; 0.001). There was no significant difference between the study groups in either time between the last chemotherapy treatment and death, inpatient SPC or place of death.<br/><br/>Conclusion<br/>Early integration of home-based SPC in advanced GI cancer patients significantly reduces emergency healthcare use and hospitalisation.}},
  author       = {{Bojesson, Anders and Brun, Eva and Eberhard, Jakob and Segerlantz, Mikael}},
  issn         = {{1532-1827}},
  keywords     = {{Palliativ medicin; Palliative cancer care}},
  language     = {{eng}},
  month        = {{04}},
  pages        = {{1--7}},
  publisher    = {{Nature Publishing Group}},
  series       = {{British Journal of Cancer}},
  title        = {{The ALLAN trial: impact of early home-based palliative care on emergency care and hospitalisation in advanced gastrointestinal cancer patients}},
  url          = {{http://dx.doi.org/10.1038/s41416-026-03444-8}},
  doi          = {{10.1038/s41416-026-03444-8}},
  year         = {{2026}},
}