Nursing-led predictive symptom management in oncology palliative care: Using laboratory indicators and clinical judgment to improve patient quality of life: A systematic review.
Ateya Megahed Ibrahim, Donia Elsaid Fathi Zaghamir, Humood AlShamrany
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In 30 seconds
This systematic review examined nurse-led predictive symptom-management strategies in oncology palliative care, including the use of laboratory biomarkers alongside clinical judgment. It included 14 eligible qualitative and quantitative studies spanning randomised trials, cohorts, modelling studies, and telehealth interventions. Across the included studies, markers such as C-reactive protein, neutrophil-lymphocyte ratio, albumin, ferritin, and electrolytes were reported to predict symptom worsening or clinical decline. The review found that combining biomarkers with nursing assessment was associated with improved symptom management, fewer emergency department visits, and better continuity of care, while predictive models remained limited in clinical integration.
Key findings
- Fourteen eligible studies were included, covering randomised trials, cohorts, modelling studies, and telehealth interventions.
- C-reactive protein, neutrophil-lymphocyte ratio, albumin, ferritin, and electrolytes were reported to predict symptom exacerbation and clinical decline.
- Nurse-led approaches combining biomarkers and clinical assessment were reported to improve symptom management and continuity of care and decrease emergency department visits.
- Predictive models were described as promising, but their integration into clinical practice was limited.
Why it matters
Palliative symptoms can change quickly, and a proactive approach may help identify deterioration before symptoms become more severe. The review highlights the potential value of combining laboratory indicators with nursing assessment rather than relying solely on symptoms reported after worsening. However, the evidence spans varied study designs, and the reported promise of predictive tools does not establish their effectiveness in routine care.
What to keep in mind
The review included only 14 studies with varied designs, and predictive models had limited clinical integration. The abstract notes that further validation in real-world settings is needed.