Irene J Higginson and Barbara Gomes

In line with other work in the department looking at appropriate ways of expanding palliative care to non-malignant diseases, this study aimed to determine to what extent patients with different progressive chronic diseases have similar symptom profiles and needs. We have systematically collated and appraised the findings of 64 original studies reporting the prevalence of 11 common symptoms among patients with five far advanced diseases: cancer; acquired immunodeficiency syndrome (AIDS); heart disease; chronic obstructive pulmonary disease; or renal disease.

Although symptom assessment and designs need improvements, we found that the prevalence of the 11 symptoms was equally high across different end-stage diseases. This is illustrated in a comparative table (a grid), with the symptom prevalence across the five diseases (Solano, Gomes & Higginson, 2006). The grid also shows that three symptoms - pain, breathlessness and fatigue - were particularly common and were reported by more than 50% of patients with each disease. Our findings suggest that there is a common pathway towards death in terms of symptom experience, and that hospice and palliative care is relevant beyond cancer.