First Author, Year, Country | Design | Quality Assessment | Model | Outcome measurements | Results/Effectiveness of the model |
---|---|---|---|---|---|
Cancer | |||||
 Jordhøy et al. 2001, (Norway) [20] | Cluster Randomised Trial | 33 | Collaboration between palliative medicine unit and community service | HRQL*: physical, emotional functioning, pain, psychological distress. Place of death, hospital utilisation. | There was no evidence of any impact on the patients’ HRQL*. There was no tendency in favour of any treatment group on the main outcomes in assessments that were made within 3 months before death. |
 Smeenk et al. 1998, (The Netherlands) [21] | Quasi-experimental study | 31 | Transmural home care programme: collaboration primary care team and supporting hospital care team. | Re-hospitalization, QoL*, home death | Patients in the intervention group underwent significantly less re-hospitalization during the terminal phase of their illness; the intervention contributed significantly positive to the patients physical QoL; A higher, not significant percentage died at home. |
 Colombet et al. 2012, (France) [22] | Case series study nested in a cohort | 30 | Impact of oncologist’s awareness of PC, clinical intervention of PCT* and timing, multidisciplinary decision-making. | Indicators: location of death, number of ER* visits in last month of life, chemotherapy administration in last 14 days of life. | 58 patients died at home, 45 in an ICU or ER, and 253 in an acute care hospital; 185 patients visited the ER* in last month of life and 75 received chemotherapy in last 14 days of life. OPM* independently decreases the odds of receiving chemotherapy in last 14 days of life. Early PCT* intervention had no impact on indicators, whereas OPM* reduced the odds of persistent chemotherapy in the last 14 days of life. Decision-making with oncologists and the PC* team is the most critical parameter for improving EoLC*. |
 Schreml et al. 2000, (Germany) [23] | Observational study | 25 | Integration of PC into regular internal ward services in general hospital. | Release of pain, respiratory distress, dying in hospital, length of hospital stay. | It is possible to integrate PC into a regular internal medical ward, with positive impact on recorded outcome measures. |
End-of-life (Liverpool Care Pathway) | |||||
 Constantini et al. 2013, (Italy) [24] | Cluster Randomised Trial | 34 | LCP* for cancer patients dying in hospital medical wards. | Quality of EoLC* from perspective of bereaved family member; communication between ward staff and GPs* (VOICES)*. | Aspects of quality of EoLC* improved (emotional, spiritual needs, self-efficacy); slight improvement in communication, no significant improvement in symptom control. |
 Veerbeek et al. 2008, (The Netherlands) [25] | Uncontrolled before and after study | 27 | Effect of the LCP* on 3 health care settings (hospital, nursing home, home). | Comparison of level of documentation, symptom burden (EORTC QLQ-C30* questionnaire) and aspects of communication (VOICES)* before and after introduction of LCP*. | Introduction of LCP* increased documentation, decreased symptom burden. |
Malignant and Non-malignant Disease | |||||
 Grande et al. 2000, (UK) [26] | Randomised controlled trial | 33 | Cambridge Hospital at Home for palliative care (CHAH). | Symptom control, adequacy of care, likelihood of remaining at home in their final 2 weeks, GP visits. | CHAH appeared to be associated with better quality home care. |
 Vicente et al. 2010, (Spain) [27] | Retrospective and prospective cohort study | 30 | Influence of the Integrated Plan of PC* of the Autonomous Community of Madrid in the medical activity of a hospital based PC* unit. | Improvement in continuity of care, coordination amongst assistant bodies, increase in mean stay at the PCU*, increase in number of home deaths, etc. | PC home care improves continuity in care of patients. Transfers to intermediate stay care centers and deaths at home increased. Median stay at the PCU* decreased. |
Dementia | |||||
 Sampson et al. 2011, (UK) [28] | Randomised controlled trial | 28 | Pilot implementation of the assessment of PC needs of patients with severe dementia and discussion with principal carers to improve EoLC*. | Kessler Distress Scale, EQ-5D*, Decision Conflicts Scale, Decision Satisfaction Inventory, State Anger Scale, Life Satisfaction Scale, Satisfaction with EoLC*, Advanced Dementia Scale (FAST Scale); Pain and distress (the Abbey pain scale, the PACSLAC and the Doloplus), delirium (Confussion Assessment Method), | General unwillingness to address EoL* issues. All carers were keen to receive more information about EoL* issues in dementia, found discussions very helpful. Participation of clinical MD* team facilitated integration of intervention with the clinical service. |
Multiple Scherosis | |||||
 Higginson et al. 2009, (UK) [29] | Randomised controlled trial | 36 | Evaluation of cost-effectiveness of a new PC service for people with MS*. | Use of services, patient symptoms (UNDS*, EDSS* and POS-8*), other outcomes, caregiver burden (ZBI*). | Short-term PCT* was found to be cost-effective, reducing inpatient and community costs, caregiver burden and possibly patient pain. |
 Edmonds et al. 2010, (UK) [30] | Randomised controlled trial | 36 | Evaluation of a novel PC service. | MS Impact Scale, POS-8*, ZBI*, Modified Lawton positivity questionnaire. | MS patients who received PC* service had improvements in 5 key symptoms (pain, nausea, vomiting, mouth problems and sleeping difficulties) on the POS and improved informal caregiver wellbeing. |
HIV/AIDS | |||||
 Koffman et al. 1996, (UK) [31] | A descriptive pilot evaluation | 23 | Pilot evaluation of hospice at home service for patients with advanced HIV/AIDS; 24-h terminal care. | STAS*, evaluating pain control, other symptom control, patient/family anxiety, patient/family insight and communication between patient and family, between professionals, between professionals and patient and family. | 80 % died at home; STAS* showed improvements in items ‘other symptoms control’ and family insight. |
Chronic Heart Failure | |||||
 Pattenden et al. 2012, (UK) [32] | Non-randomised pilot evaluation | 30 | Collaborative PC* for advanced heart failure. | Death in preferred place of care; hospital admissions averted; costs of medical procedures, inpatient care and directs costs of intervention. | This pilot study provides tentative evidence that a collaborative home-based PC* service for patients with advanced CHF may increase the likelihood of death in place of choice and reduce inpatient admissions. |
Advanced Chronic Disease | |||||
 Navarro et al., 2011, (Spain) [33] | Observational, retrospective and descriptive study | 26 | EoLC* of advanced chronic non-cancer patients identified by multidimensional evaluation and interdisciplinary teamwork in a medium and long term hospital. | General data, terminal criteria, diagnostic and prognostic information, development of advance directives, limiting levels of effort care, times from admission, risk of complicated bereavement. | Identification of advanced chronic non-cancer patients and their needs by interdisciplinary teamwork enabled indication for PC soon after admission and ensured appropriate care during their stay. |