The controversial Liverpool Care Pathway has little clinical benefit over standard care but may improve patient dignity, the first randomised control trial of the approach has found.
The Liverpool Care Pathway Italian Cluster Trial Study Group assessed the impact of the Italian version of the end of life care programme on the quality of care of adult patients dying with cancer in 16 hospital wards across Italy.
Researchers interviewed 119 family members whose relatives were cared for on the Liverpool Care Pathway and 113 who were not.
Wards in which the pathway was used were rated slightly better than those that followed standard healthcare practice. However, researchers said it was not a significant difference.
Relatives rated the respect, dignity, and kindness shown to their family member and control of breathlessness better in wards using the Liverpool Care Pathway. There was no difference in survival times between the two approaches.
The pathway is being scrapped by the English government following controversy over its use in NHS hospitals and allegations clinicians were putting patients onto the pathway without their consent.
The authors of the study, published in The Lancet and carried out by King’s College London and the Research Institute S Maria Nuova of Reggio Emilia in Italy said the findings showed the importance of basing the pathway’s replacement on scientific evidence.
Professor Irene Higginson, co-author of the study and director of the Cicely Saunders Institute at King’s College London, said: “We must face this challenge head-on and ensure scientific evidence forms the foundations for any new initiative if end-of-life care is to be genuinely improved for patients and their families in England.”