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May 7, 2026BMJ Supportive & Palliative Care0 citations

Target symptom-guided prescribing in home-based specialist palliative care: prospective quality improvement study

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RGRaffaele GiustiDMDaniele MarinelliGFGuglielmo Fumi

Key Points

  • To evaluate the impact of pharmacotherapy focused on the patient's prioritized symptom in advanced cancer.
  • Prospective quality improvement design
  • Examined correlations using Pearson's r
  • Target symptom identified as pain in 45.7% of patients
  • Target symptom intensity halved within 2 weeks
  • Global symptom burden reduced by 39%
  • Supports a less-is-more approach to minimize polypharmacy

Abstract

OBJECTIVES: This study aims to assess whether single-agent pharmacotherapy directed at the patient-prioritised, highest-scoring PERSONS symptom (target symptom) produces concurrent improvements in both the target symptom and overall symptom burden in advanced-cancer patients. METHODS: ; Pearson's r examined correlations. RESULTS: = 0.65; both p<0.0001). Pain was the predominant target symptom (45.7 %). CONCLUSIONS: Focusing on a single, evidence-based drug on the patient-defined dominant symptom halved target-symptom intensity and reduced global symptom burden by 39% within 2 weeks. These findings support a pragmatic 'less-is-more' paradigm that may minimise polypharmacy while delivering broad symptomatic benefit in advanced cancer.

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Cite This Study

Giusti et al. (2026) studied this question.

synapsesocial.com/papers/69fbf004164b5133a91a4341https://doi.org/10.1136/spcare-2026-006159
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