Specialist palliative care services for older people in primary care: A systematic review using narrative synthesis. There is recognition that older people with incurable conditions should have access to specialist palliative care services. However, it remains unclear which activities and outcomes these services entail for older people in primary care and to which patients they are provided.The aim of this review was to identify the criteria for referral to specialist services; who provides (...) specialist palliative care; through which activities and with which frequency; which outcomes are reported; and which suggestions are made to improve services.Systematic review of the literature and narrative synthesis. Quality appraisal and selection of studies were performed independently by two researchers. Participant characteristics, intervention features, outcome data and suggestions for improvement were retrieved.Embase, Medline, Web of Science, Cochrane, Google Scholar, PsycINFO and CINAHL EBSCO

[Cannabis and cannabinoids in palliative care]. Cannabis and cannabinoids are discussed as a potential treatment for a broad spectrum of diseases and symptoms. This article presents current evidence for the use of cannabis and cannabinoids in palliative care and delivers background information. For this purpose recent literature was examined and evaluated. The authors focused on a systematic review and meta-analysis of cannabinoids in palliative care by Mücke et al.Overall, there is no high (...) -quality evidence for the use of cannabis and cannabinoids in palliative care. Cannabinoids may be considered as a therapeutic attempt in the treatment of cancer pain and weight gain in patients with HIV as well as other symptoms (such as nausea and loss of appetite) if established treatments fail.Further studies involving more patients are needed to evaluate the therapeutic potential of cannabis and cannabinoids. However, special conditions in the field of palliative care make it difficult to carry

Multi-disciplinary palliative care is effective in people with symptomatic heart failure: A systematic review and narrative synthesis. Despite recommendations, people with heart failure have poor access to palliative care.To identify the evidence in relation to palliative care for people with symptomatic heart failure.Systematic review and narrative synthesis. (PROSPERO CRD42016029911).Databases (Medline, Cochrane database, CINAHL, PsycINFO, HMIC, CareSearch Grey Literature), reference lists (...) , with lower risk of bias, using a multi-disciplinary specialist palliative care intervention showed statistically significant benefit for patient-reported outcomes (symptom burden, depression, functional status, quality of life), resource use and costs of care. Benefit was not seen in studies with a single component/discipline intervention or with higher risk of bias. Possible contamination in some studies may have caused under-estimation of effect and missing data may have introduced bias

Identification and evaluation of observational measures for the assessment and/or monitoring of level of consciousness in adult palliative care patients: A systematic review for I-CAN-CARE. The use of observational measures to assess palliative care patients' level of consciousness may improve patient care and comfort. However, there is limited knowledge regarding the validity and reliability of these measures in palliative care settings.To identify and evaluate the psychometric performance (...) reported information about psychometric performance of just eight tools. All other studies used either ad hoc measures for which no formal validation had been undertaken (n = 21) or established tools mainly developed and validated in non-palliative care settings (n = 37). The Consciousness Scale for Palliative Care and a modified version of the Richmond Agitation-Sedation Scale received the highest ratings in our appraisal, but, since psychometric evidence was limited, no tool could be assessed for all

Opportunities to Improve Utilization of Palliative Care among Adults with Cystic Fibrosis: A Systematic Review. Individuals with cystic fibrosis (CF) frequently survive into adulthood, and many have multifaceted symptoms that impair quality of life.We conducted a systematic review to investigate opportunities to improve utilization of palliative care among adults with CF.We searched PubMed, Embase, Scopus, Web of Science, and CINAHL databases from inception until September 27, 2018 (...) during their terminal hospitalization. Finally, treatment from a palliative care specialist was associated with a higher prevalence of patient completion of advanced directives, decreased likelihood of death in intensive care unit, and decreased use of mechanical ventilation at EOL.Adults with CF often have untreated symptoms, and many opportunities exist for palliative care specialists to improve ACP completion and quality of EOL care.Copyright © 2019 American Academy of Hospice and Palliative

Palliative Care Opportunities Among Adults With Congenital Heart Disease-A Systematic Review. Little is known about advance care planning (ACP) and palliative care needs among adults with congenital heart disease (ACHD).The objective of this study was to identify and synthesize studies concerning palliative care among ACHD patients.We searched five electronic databases (PubMed, Embase, SCOPUS, Web of Science, and CINAHL) using the keywords palliative care and congenital heart disease. Inclusion (...) that many ACHD patients recognize the value of initiating end-of-life and goals of care conversations early on in the course of illness. Future studies investigating communication and implementation strategies of ACP as well as the symptom experience of patients with ACHD are needed.Copyright © 2019 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Impact of Specialized Pediatric Palliative Care: A Systematic Review. Specialized pediatric palliative care (SPPC) is increasingly involved in the care of seriously ill children, yet the evidence on its impact has not been comprehensively reviewed.The objective of this study was to assess the effects of providing SPPC to seriously ill children on patient-, caregiver-, and systems-level outcomes.We performed a Systematic Review following Cochrane methods.Medline, Embase, PsycINFO, Global Health (...) outcome showed this consistency.Receiving SPPC was associated with better child quality of life. However, the paucity and low certainty of the evidence precluded any firm recommendations about SPPC practice. Larger collaborative networks and greater consensus regarding SPPC research standards are needed.Copyright © 2019 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

A systematic review and meta-analysis of randomized controlled trials of palliative care for pain among Chinese adults with cancer. Pain is one of the most common symptoms that has a severe impact on quality of life and is associated with numerous psychosocial issues in cancer patients. Palliative care, which is a recent development in China, mainly focuses on symptom control and provides psychosocial support in order to improve quality of life for terminally ill patients. This meta-analysis (...) aimed to evaluate the effects of palliative care on cancer pain in China.The four most comprehensive Chinese academic databases-CNKI, Wanfang, Vip and CBM-were searched from their inception until July 2019. Medline/PubMed, Web of Science, EBSCO and internet search (Google and Google Scholar) were also searched. Randomized controlled studies assessing the effects of palliative care on cancer pain were analyzed. The pooled random-effect estimates of standardized mean difference (SMD) and 95

Perinatal Palliative Care Perinatal Palliative Care - ACOG Menu ▼ Perinatal Palliative Care Page Navigation ▼ Number 786 Committee on Obstetric Practice Committee on Ethics The American Academy of Pediatrics and the Society for Maternal-Fetal Medicine endorse this document. This Committee Opinion was developed by the Committee on Obstetric Practice with the assistance of committee member Russell S. Miller, MD and the American Academy of Pediatrics’ liaison member James J. Cummings, MD (...) ; and the Committee on Ethics with the assistance of the American Academy of Pediatrics’ liaison member Robert Macauley, MD and the Society for Maternal-Fetal Medicine’s liaison member Steven J. Ralston, MD, MPH. Perinatal Palliative Care ABSTRACT : Perinatal palliative care refers to a coordinated care strategy that comprises options for obstetric and newborn care that include a focus on maximizing quality of life and comfort for newborns with a variety of conditions considered to be life-limiting in early

Do patients, families, and healthcare teams benefit from the integration of palliative care in burn intensive care units? Results from a systematic review with narrative synthesis. Burn units are intensive care facilities specialized in the treatment of patients with severe burns. As burn injuries have a major impact in physical, psychosocial, and spiritual health, palliative care can be a strengthening component of integrated care.To review and appraise the existing evidence about (...) the integration of palliative care in burn intensive care units with respect to (1) the concept, model and design and (2) the benefits and outcomes of this integration.A systematic review was conducted following PRISMA guidelines. Protocol registered with PROSPERO (CRD42018111676).Five electronic databases were searched (PubMed/NLM, Web of Science, MEDLINE/TR, Ovid, and CINAHL/EBSCO) until May 2019. A narrative synthesis of the findings was constructed. Hawker et al.'s tool was used for quality appraisal.A

Palliative care for older South Asian migrants: a systematic review. South Asian migrants have a higher burden of life-threatening diseases and chronic diseases compared to other ethnic groups. Yet, knowledge gaps remain around their palliative care needs in the host countries. The aim of the review was to present results from a systematic literature review of available international evidence on experiences with and perspectives on palliative care among older South Asian migrants, relatives (...) , and healthcare providers.A systematic review in accordance with PRISMA guidelines was conducted in February 2018, searching PubMed, CINAHL, PsychINFO, and EMBASE databases. PROSPERO #CRD42018093464. Studies included empirical research, providing international evidence on experiences and perspectives on palliative care of South Asian migrants and were published between 2000 and 2018. Thematic synthesis was used to analyze data.A total of 30 articles were included: qualitative (24), quantitative (5), and mixed

Inclusion, characteristics and outcomes of people requiring palliative care in studies of non-pharmacological interventions for delirium: A systematic review. Delirium is common, distressing, serious and under-researched in specialist palliative care settings.To examine whether people requiring palliative care were included in non-pharmacological delirium intervention studies in inpatient settings, how they were characterised and what their outcomes were.Systematic review (PROSPERO 2017 (...) CRD42017062178).Systematic search in March 2017 for non-pharmacological delirium intervention studies in adult inpatients. Database search terms were 'delirium', 'hospitalisation', 'inpatient', 'palliative care', 'hospice', 'critical care' and 'geriatrics'. Scottish Intercollegiate Guidelines Network methodological checklists guided risk of bias assessment.The 29 included studies were conducted between 1994 and 2015 in diverse settings in 15 countries (9136 participants, mean age = 76.5 years (SD = 8.1), 56

Models of non-hospice palliative care: a review. Palliative care offers patients with a serious illness and their families access to services that can improve quality of life, mood, and symptoms. However, the term palliative care is often confused with end of life or hospice services limiting its application to persons with chronic illnesses who might benefit. Non-hospice palliative care is a term that is emerging to more accurately reflect the broader care model that palliative care represents (...) . The aim of this review was to identify the characteristics of published nonhospice palliative care interventions. We derived our sample predominantly from a recently published systematic review and meta-analysis and selected studies published since the review. Inclusion criteria were: self-described palliative care intervention studies using randomized designs for participants with lifelimiting illnesses aged 18 years or older. These 38 studies fell into 3 broad categories: primary, specialty

Palliative care interventions in intensive care unit patients - a systematic review protocol. Even though data suggest that palliative care (PC) improves patient quality of life, caregiver burden, cost, and intensive care unit (ICU) length of stay, integration of PC in the ICU is far from being universally accepted. Poor understanding of what PC provides is one of the barriers to the widespread implementation of their services in ICU. Evidence suggests that the availability of specialist PC (...) is lacking in most European countries and provided differently depending on geographical location. The aim of this systematic review is to compare the numbers and types of PC interventions and gauge their impact on stakeholder outcomes and ICU resource utilisation.We will undertake a systematic review of the published peer-reviewed journal articles; our search will be carried out MEDLINE, Embase, Cochrane, CINAHL, and PsycINFO. The search strategy will include variations in the term 'palliative care

Diabetes-related symptoms, acute complications and management of diabetes mellitus of patients who are receiving palliative care: a protocol for a systematic review. Worldwide, an estimated 40 million people are in need of palliative care each year, but only 14% receive it. The incidence of diabetes mellitus (DM) in patients receiving palliative care is higher than in the general population. This association is intended to grow as a result of the rising burden of DM worldwide, ageing (...) populations and the improved overall survival time of several diseases over the last few decades. Recommendations for DM management in the context of palliative care are mainly based on expert opinion as there is a lack of suitable evidence base and randomised clinical trials in palliative care are scarce. The aim of our systematic review is to identify the best DM management practices in order to reduce important DM-related symptoms and acute complications in patients receiving palliative care.The

Consumer and carer leadership in palliative care academia and practice: A systematic review with narrative synthesis. Contemporary health policies call for consumers to be part of all aspects of service planning, implementation, delivery and evaluation. The extent to which consumers are part of the systemic decision-making levels of palliative care appears to vary between and within services and organisations.The aim of this systematic review is to develop understandings about consumer (...) and carer leadership in palliative care.A systematic, narrative synthesis approach was adopted due to the heterogeneity of included studies. The review was registered on PROSPERO prospectively (PROSPERO 2018 CRD42018111625).PubMed, Scopus and PsycINFO were searched for all studies published in English specifically focusing on consumers' leadership in palliative care organisations and systems. Articles were appraised for quality using a modified JBI-QARI tool.Eleven studies met the inclusion criteria

Palliative care transitions from acute care to community-based care - a systematic review. Although the literature on transitions from hospital to the community is extensive, little is known about this experience within the context of palliative care (PC).We conducted a systematic review to investigate the impact of receiving palliative care in hospital on the transition from hospital to the community.We systematically searched MEDLINE, Embase, ProQuest, and CINAHL from 1995 until April 10 (...) , 2018, and extracted relevant references. Eligible articles were published in English, included adult patients receiving PC as inpatients, and explored transitions from hospital to the community.A total of 1514 studies were identified and eight met inclusion criteria. Studies were published recently (>2012; n = 7, 88%). Specialist PC interventions were delivered by multidisciplinary care teams as part of inpatient PC triggers, discharge planning programs, and transitional care programs. Common

The incidence and prevalence of delirium across palliative care settings: A systematic review. Delirium is a common and distressing neurocognitive condition that frequently affects patients in palliative care settings and is often underdiagnosed.Expanding on a 2013 review, this systematic review examines the incidence and prevalence of delirium across all palliative care settings.This systematic review and meta-analyses were prospectively registered with PROSPERO and included a risk of bias (...) assessment.Five electronic databases were examined for primary research studies published between 1980 and 2018. Studies on adult, non-intensive care and non-postoperative populations, either receiving or eligible to receive palliative care, underwent dual reviewer screening and data extraction. Studies using standardized delirium diagnostic criteria or valid assessment tools were included.Following initial screening of 2596 records, and full-text screening of 153 papers, 42 studies were included. Patient

Clinical Practice Guidelines for Quality Palliative Care Clinical Practice Guidelines for Quality Palliative Care | From the American Academy of Pediatrics | Pediatrics '); document.write(''); } function OAS_AD(pos) { if (OAS_version >= 11 && typeof(OAS_RICH)!='undefined') { OAS_RICH(pos); } else { OAS_NORMAL(pos); } } //--> Search for this keyword Source User menu Sections Sign up for highlighting editor-chosen studies with the greatest impact on clinical care. Clinical Practice Guidelines (...) for Quality Palliative Care The American Academy of Pediatrics has endorsed the following publication: National Coalition for Hospice and Palliative Care, National Consensus Project. Clinical Practice Guidelines for Quality Palliative Care . 4th ed. Richmond, VA: National Coalition for Hospice and Palliative Care; 2018. Available at: . All statements of endorsement from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, retired, or revised at or before

Real-world ethics in palliative care: protocol for a systematic review of the ethical challenges reported by specialist palliative care practitioners in their clinical practice. Ethical issues arise daily in the delivery of palliative care. Despite much (largely theoretical) literature, evidence from specialist palliative care practitioners (SPCPs) about real-world ethical challenges has not previously been synthesised. This evidence is crucial to inform education and training and adequately (...) . Keywords will be developed from scoping searches, consultation with information specialists and reference to key systematic reviews in palliative care and bioethics. Reference lists of included studies will be hand-searched. 10% of retrieved titles and abstracts will be independently dual screened, as will all full text papers. Quality will be dual assessed using the Mixed-Methods Appraisal Tool (2018). Narrative synthesis following Popay et al (2006) will be used to synthesise findings. The strength