Specialist palliative care services for older people in primary care: A systematic review using narrative synthesis

Kim de Nooijer, Yolanda Wh Penders, Lara Pivodic, Nele J Van Den Noortgate, Peter Pype, Lieve Van den Block

Research output: Contribution to journalScientific reviewpeer-review

8 Citations (Scopus)
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Abstract

BACKGROUND: 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.

AIM: 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.

DESIGN: 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.

DATA SOURCES: Embase, Medline, Web of Science, Cochrane, Google Scholar, PsycINFO and CINAHL EBSCO databases (until June 2019).

RESULTS: Ten eligible articles, three qualitative, three quantitative, three mixed-method and one narrative review, were identified. Referral criteria were mainly based on patient characteristics such as diagnosis. The specialist services involved a variety of activities and outcomes and descriptions were often lacking. Services could be improved regarding the information flow between healthcare professionals, greater in-depth palliative care knowledge for case managers and social workers, identification of a key worker and support for family carers.

CONCLUSION: The limited evidence available shows areas for improvement of the quality of and access to specialist services for older people, such as support for family carers. In addition, this review underscores the need for comprehensive reporting of interventions and the use of consensus-based outcome measures.

Original languageEnglish
Pages (from-to)32-48
Number of pages17
JournalPalliative Medicine
Volume34
Issue number1
Early online date28 Sep 2019
DOIs
Publication statusPublished - Jan 2020

Bibliographical note

Funding Information:
The authors would like to thank Wichor Bramer, a biomedical information specialist at the Erasmus University Medical Centre Rotterdam, for helping with developing and conducting the search strategy for this systematic review. The authors thank Jane Ruthven for linguistic help. The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This work was supported by the Research Foundation-Flanders (G.0303.16N), by an AXA Research Fund Postdoctoral grant (2016-2018) and Lara Pivodic is a Postdoctoral Fellow of the Research Foundation-Flanders (no grant number).

Funding Information:
The limited evidence available shows areas for improvement of the quality of and access to specialist services for older people, such as support for family carers. In addition, this review underscores the need for comprehensive reporting of interventions and the use of consensus-based outcome measures. Older people palliative care primary care community care systematic review Fonds Wetenschappelijk Onderzoek https://doi.org/10.13039/501100003130 G.0303.16N edited-state corrected-proof The authors would like to thank Wichor Bramer, a biomedical information specialist at the Erasmus University Medical Centre Rotterdam, for helping with developing and conducting the search strategy for this systematic review. The authors thank Jane Ruthven for linguistic help. Author contributions All authors contributed to study conception and design; acquisition of data; analysis and interpretation of data; and drafting and critical revision of the manuscript. Also, the authors have approved the final manuscript and agree to be accountable for all aspects of the work. Questions related to the accuracy or integrity of any part of the work will be appropriately investigated and resolved. Declaration of conflicting interests The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article. Funding The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This work was supported by the Research Foundation-Flanders (G.0303.16N), by an AXA Research Fund Postdoctoral grant (2016-2018) and Lara Pivodic is a Postdoctoral Fellow of the Research Foundation-Flanders (no grant number). ORCID iD Kim de Nooijer https://orcid.org/0000-0003-2887-6832 Supplemental material Supplemental material for this article is available online.

Publisher Copyright:
© The Author(s) 2019.

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

Keywords

  • Older people
  • community care
  • palliative care
  • primary care
  • systematic review

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