Table 3 Characteristics of included Cancer Guidelines
Cancer guidelines | |||
|---|---|---|---|
Title/Country/Year | Setting | Emanuel’s criteria (EMC) | Quality of evidence |
Interdisciplinary guideline of quality for early detection, diagnosis and treatment of different stages of prostate cancer/Germany/2011. [31] | inpatient/outpatient | 7 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of PC introduction, Patient’s goals, Suffering reduction, ACP, Involvement of PC team. | High |
Practice guideline for palliative care/Germany/2009. [32] | outpatient | 9 EMC: Holistic assessments, Timing of PC introduction, Patient’s goals, Continuous goal adjustment, Suffering reduction, ACP, Involvement of PC team, Last hours of living care, Grief and bereavement care. | Low |
Interdisciplinary guidelines for the diagnosis, treatment and follow-up of breast cancer/Germany/2012. [33] | inpatient/outpatient | 9 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of holistic assessments, Timing of PC introduction, Patient’s goals, Continuous goal adjustment, Suffering reduction, Involvement of PC team, Last hours of living care. | High |
Guideline: Prevention, Diagnosis, Therapy, and Follow-up of Lung Cancer. (Germany, 2010) [34] | inpatient/outpatient | 9 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of PC introduction, Patient’s goals, Continuous goal adjustment, Suffering reduction, ACP, Involvement of PC team, Last hours of living care. | High |
Malignant melanoma S3-guideline: Diagnosis, treatment and aftercare of melanoma. (Germany, 2013) [35] | inpatient/outpatient | 7 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of holistic assessments, Timing of PC introduction, Suffering reduction, ACP, Involvement of PC team. | High |
Cancer pain. (Germany, 2007) [36] | inpatient/outpatient | 3 EMC: Holistic assessments, Timing of holistic assessments, Continuous goal adjustment. | High |
Directive of the Federal Joint Committee on the Regulation of specialized outpatient palliative care. (Germany, 2007). [37] | outpatient | 6 EMC: Holistic assessments, Patient’s goals, Suffering reduction, ACP, Involvement of PC team, Last hours of living care. | Very low |
National Practice Guideline pancreatic cancer. (Belgium, 2009) [38] | inpatient | 3 EMC: Holistic assessments, Timing of PC introduction, Involvement of PC team. | High |
Small cell and non- small cell lung cancer: diagnosis, treatment and follow-up. (Belgium, 2013) [39] | inpatient | 2 EMC: Patient’s goals, ACP. | High |
National Practice Guideline of oesophageal and stomach cancer – UPDATE. (Belgium, 2012) [40] | inpatient | 4 EMC: Holistic assessments, Timing of PC introduction, Suffering reduction, Involvement of PC team. | High |
Palliative Care Unit: Standards and Recommendations. (Spain, 2009) [41] | inpatient/outpatient | 8 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of PC introduction, Patient’s goals, Suffering reduction, ACP, Involvement of PC team, Grief and bereavement care. | High |
Clinical Practice Guidelines on Palliative Care. (Spain, 2008) [42] | inpatient/outpatient | 10 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of PC introduction, Patient’s goals, Continuous goal adjustment, Suffering reduction, ACP, Involvement of PC team, Last hours of living care, Grief and bereavement care. | High |
Palliative Care Guideline. (Spain, no date available) [43] | inpatient/outpatient | 3 EMC: Involvement of PC team, Last hours of living care, Grief and bereavement care. | Very low |
Palliative Care Guideline in the Community of Madrid. (Spain, 2008) [44] | inpatient/outpatient | 5 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of PC introduction, Suffering reduction, Last hours of living care. | Very low |
Clinical recommendations guideline: colorectal cancer. (Spain, 2006). [45] | 4 EMC: Holistic assessments, Timing of PC introduction, Continuous goal adjustment, Grief and bereavement care. | High | |
Guideline Care in the dying phase. (The Netherlands, 2010) [46] | inpatient/outpatient | 8 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of PC introduction, Patient’s goals, Suffering reduction, ACP, Last hours of living care, Grief and bereavement care. | Low |
Guideline Leptomeningeal metastases. (The Netherlands, 2010) [47] | inpatient/outpatient | 4 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of PC introduction, Suffering reduction. | High |
Guideline Oncologic Rehabilitation. (The Netherlands, 2011) [48] | inpatient/outpatient | 6 EMC: Holistic assessments, Timing of holistic assessments, Timing of PC introduction, Patient’s goals, Continuous goal adjustment, Suffering reduction. | Medium |
Guideline NSCLC. (The Netherlands, 2011). [49] | inpatient/outpatient | 5 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of holistic assessments, Patient’s goals, Suffering reduction. | High |
Guideline Melanoma. (The Netherlands, 2013) [50] | inpatient/outpatient | 3 EMC: Discussion of illness limitations and prognosis, Timing of PC introduction, Suffering reduction. | High |
Guideline Oesophagus carcinoma. (The Netherlands, 2010) [51] | inpatient/outpatient | 8 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of holistic assessments, Timing of PC introduction, Patient’s goals, Continuous goal adjustment, Suffering reduction, ACP. | High |
Guideline Pancreas carcinoma. (The Netherlands, 2011) [52] | inpatient/outpatient | 3 EMC: Discussion of illness limitations and prognosis, Patient’s goals, Suffering reduction. | High |
Guideline cervix carcinoma. (The Netherlands, 2012) [53] | inpatient/outpatient | 4 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Suffering reduction, ACP, Involvement of PC team. | High |
Guideline Endometrial carcinoma. (The Netherlands, 2011) [54] | inpatient/outpatient | 2 EMC: Discussion of illness limitations and prognosis, Involvement of PC team. | High |
Guideline Sarcoma carcino-sarcoma uterus. (The Netherlands, 2010) [55] | inpatient/outpatient | 2 EMC: Holistic assessments, Involvement of PC team. | Low |
Guideline Hypo-pharynx carcinoma. (The Netherlands, 2010) [56] | inpatient/outpatient | 5 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of holistic assessments, Timing of PC introduction, Suffering reduction. | High |
Guideline Larynx carcinoma. (The Netherlands, 2010) [57] | inpatient/outpatient | 5 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of holistic assessments, Timing of PC introduction, Suffering reduction. | High |
Guideline Mouth and oropharynx carcinoma. (The Netherlands, 2004) [58] | inpatient/outpatient | 5 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of holistic assessments, Timing of PC introduction, Suffering reduction. | High |
Guideline Breast cancer. (The Netherlands, no date available) [59] | inpatient/outpatient | 4 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of holistic assessments, Suffering reduction. | High |
Guideline Prostate carcinoma. (The Netherlands, 2007) [60] | inpatient/outpatient | 3 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Patient’s goals. | High |
Professional Guideline (Directive) of the Hungarian Public Healthcare. (Hungary, 2013) [61] | inpatient | 10 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of holistic assessments, Patient’s goals, Continuous goal adjustment, Suffering reduction, ACP, Involvement of PC team, Last hours of living care, Grief and bereavement care. | Medium |
Recommendations for the development of an integrative and complex palliative care in Hungary. (Hungary, 2013) [62] | inpatient/outpatient | 8 EMC: Discussion of illness limitations and prognosis, Timing of holistic assessments, Timing of PC introduction, Patient’s goals, Continuous goal adjustment, Suffering reduction, ACP, Grief and bereavement care. | High |
Guidance on Cancer Services: Improving Supportive and Palliative Care for Adults with Cancer. (UK, 2004) [63] | inpatient/outpatient | 9 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of holistic assessments, Patient’s goals, Suffering reduction, ACP, Involvement of PC team, Last hours of living care, Grief and bereavement care. | High |
Making good care better: National practice statements for general palliative care in adult care homes in Scotland. (UK-Scotland, 2006) [64] | outpatient | 8 EMC: Holistic assessments, Patient’s goals, Continuous goal adjustment, Suffering reduction, ACP, Involvement of PC team, Last hours of living care, Grief and bereavement care. | Low |
The diagnosis and treatment of lung Cancer-updated. (UK, 2011) [65] | inpatient | 4 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of holistic assessments, Suffering reduction. | High |
Head and Neck Cancer: Multidisciplinary Management Guidelines. (UK, 2011) [66] | inpatient/outpatient | 7 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Patient’s goals, Continuous goal adjustment, Suffering reduction, Involvement of PC team, Last hours of living care. | High |
Guidelines for supportive care in multiple myeloma 2011. (UK, 2011) [67] | inpatient | 4 EMC: Holistic assessments, Timing of holistic assessments, Suffering reduction, ACP, Last hours of living care. | High |
The NICE Guidance on Supportive and Palliative Care Implications for Oncology Teams. (UK, 2004) [68] | inpatient | 5 EMC: Holistic assessments, Patient’s goals, Suffering reduction, Involvement of PC team, Grief and bereavement care. | High |
Metastatic malignant disease of unknown primary origin. Diagnosis and management of metastatic malignant disease of unknown primary origin. (UK, 2010) [69] | inpatient | 3 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Continuous goal adjustment. | High |
Palliative and End of Life Care Indicators. (UK-Scotland, 2013) [70] | inpatient/outpatient | 3 EMC: Discussion of illness limitations and prognosis, Patient’s goals, ACP. | Low |
Core competencies in palliative care: an EAPC White Paper on palliative care education. Parts 1 & 2. (UK, 2013) [71] | inpatient/outpatient | 8 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of holistic assessments, Patient’s goals, Continuous goal adjustment, ACP, Involvement of PC team, Grief and bereavement care. | Low |
Dying well at home: the case for integrated working: Guide 48. (UK, 2013) [72] | inpatient/outpatient | 7 EMC: Holistic assessments, Patient’s goals, Suffering reduction, ACP, Involvement of PC team, Last hours of living care, Grief and bereavement care. | Low |
RCGP commissioning guidance in end of life care : guidance for GPs, clinical commissioning group advisers. (UK, 2013) [73] | inpatient/outpatient | 7 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Patient’s goals, Continuous goal adjustment, Involvement of PC team, Last hours of living care, Grief and bereavement care. | Low |
Optimising the role and value of the interdisciplinary team: providing person centred end of life care. (UK, 2013) [74] | inpatient/outpatient | 9 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of holistic assessments, Patient’s goals, Continuous goal adjustment, ACP, Involvement of PC team, Last hours of living care, Grief and bereavement care. | Low |
Strategy for adult palliative and end of life care services. (UK, 2013) [75] | inpatient/outpatient | 8 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Patient’s goals, Continuous goal adjustment, Suffering reduction, Involvement of PC team, Last hours of living care, Grief and bereavement care. | Low |
End of Life Care Strategy: Fourth Annual Report. (UK, 2012) [76] | inpatient/outpatient | 3 EMC: ACP, Last hours of living care, Grief and bereavement care. | High |
Matters of life and death: helping people to live well until they die. General practice guidance for implementing the RCGP/RCN end of life care patient charter. (UK, 2012) [77] | inpatient/outpatient | 11 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of holistic assessments, Timing of PC introduction, Patient’s goals, Continuous goal adjustment, Suffering reduction, ACP, Involvement of PC team, Last hours of living care, Grief and bereavement care. | High |
End of life care for adults in the Emergency Department. (UK, 2012) [78] | inpatient | 4 EMC: Discussion of illness limitations and prognosis, Timing of PC introduction, ACP, Involvement of PC team. | High |
CMG42 End of life care for adults. (UK, 2011) [79] | inpatient/outpatient | 11 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of holistic assessments, Timing of PC introduction, Patient’s goals, Continuous goal adjustment, Suffering reduction, ACP, Involvement of PC team, Last hours of living care, Grief and bereavement care. | High |
Commissioning guidance for specialist palliative care : helping to deliver commissioning objectives. (UK, 2012) [80] | inpatient/outpatient | 6 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of PC introduction, Patient’s goals, ACP, Involvement of PC team. | Low |
Commissioning person centred end of life care. (UK, 2012) [81] | inpatient/outpatient | 2 EMC: ACP, Involvement of PC team. | Low |
Quality standard for end of life care for adults. (UK, 2011) [82] | inpatient/outpatient | 8 EMC: Holistic assessments, Timing of holistic assessments, Patient’s goals, Continuous goal adjustment, ACP, Involvement of PC team, Last hours of living care, Grief and bereavement care. | High |
Advanced breast cancer: Diagnosis and treatment. (UK, 2009) [83] | inpatient/outpatient | 3 EMC: Holistic assessments, Timing of holistic assessments, Involvement of PC team. | High |
Review of palliative care services in Scotland. (UK-Scotland, 2008) [84] | inpatient/outpatient | 4 EMC: Holistic assessments, Patient’s goals, ACP, Involvement of PC team. | High |
Living and Dying Well: A national action plan for palliative and end of life care in Scotland. (UK-Scotland, 2008) [85] | inpatient/outpatient | 8 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Timing of holistic assessments, Timing of PC introduction, Patient’s goals, Suffering reduction, ACP, Involvement of PC team. | Low |
Metastatic spinal cord compression: Diagnosis and management of patients at risk of or with metastatic spinal cord compression. (UK, 2008) [86] | inpatient/outpatient | 2 EMC: Holistic assessments, Involvement of PC team. | High |
End of life care. (UK, 2008) [87] | inpatient/outpatient | 5 EMC: Holistic assessments, Patient’s goals, ACP, Last hours of living care, Grief and bereavement care. | Medium |
National Care Standards: Hospice Care. (UK, 2005) [88] | inpatient/outpatient | 2 EMC: Last hours of living care, Grief and bereavement care. | Low |
Clinical Standards: Specialist palliative care. (UK, 2002) [89] | inpatient | 7 EMC: Discussion of illness limitations and prognosis, Holistic assessments, Patient’s goals, Continuous goal adjustment, ACP, Involvement of PC team, Grief and bereavement care. | Low |
Improving outcomes in gynaecological cancer: The Manual. (UK, 1999) [90] | inpatient/outpatient | 2 EMC: Holistic assessments, Suffering reduction. | High |