The challenges of caring for people dying from COVID-19:a multinational, observational study (CovPall)

Oluyase, Adejoke and Hocaoglu, Mevhibe and Cripps, Rachel and Maddocks, Matthew and Walshe, Catherine and Fraser, Lorna and Preston, Nancy and Dunleavy, Lesley and Bradshaw, Andy and Murtagh, Fliss and Bajwah, Sabrina and Sleeman, Katherine and Irene, Higginson (2021) The challenges of caring for people dying from COVID-19:a multinational, observational study (CovPall). Journal of Pain and Symptom Management. ISSN 0885-3924

[img]
Text (CovPall_JPSM_Overall_AAM_5.2.21)
CovPall_JPSM_Overall_AAM_5.2.21.pdf - Accepted Version
Restricted to Repository staff only until 5 February 2022.
Available under License Creative Commons Attribution-NonCommercial-NoDerivs.

Download (274kB)

Abstract

Context Systematic data on the care of people dying with COVID-19 are scarce. Objectives To understand the response of and challenges faced by palliative care services during the COVID-19 pandemic, and identify associated factors. Methods We surveyed palliative care and hospice services, contacted via relevant organisations. Multivariable logistic regression identified associations with challenges. Content analysis explored free text responses. Results 458 services responded; 277 UK, 85 rest of Europe, 95 rest of the world; 81% cared for patients with suspected or confirmed COVID-19, 77% had staff with suspected or confirmed COVID-19; 48% reported shortages of Personal Protective Equipment (PPE), 40% staff shortages, 24% medicines shortages, 14% shortages of other equipment. Services provided direct care and education in symptom management and communication; 91% changed how they worked. Care often shifted to increased community and hospital care, with fewer admissions to inpatient palliative care units. Factors associated with increased odds of PPE shortages were: charity rather than public management (OR 3.07, 95% CI 1.81-5.20), inpatient palliative care unit rather than other settings (OR 2.34, 95% CI 1.46-3.75). Being outside the UK was associated with lower odds of staff shortages (OR 0.44, 95% CI 0.26-0.76). Staff described increased workload, concerns for their colleagues who were ill, whilst expending time struggling to get essential equipment and medicines, perceiving they were not a front-line service. Conclusion Palliative care services were often overwhelmed, yet felt ignored in the COVID-19 response. Palliative care needs better integration with health care systems when planning and responding to future epidemics/pandemics.

Item Type:
Journal Article
Journal or Publication Title:
Journal of Pain and Symptom Management
Additional Information:
This is the author’s version of a work that was accepted for publication in Journal of Pain and Symptom Management. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Pain and Symptom Management, ?, ?, 2021 DOI: 10.1016/j.jpainsymman.2021.01.038
Uncontrolled Keywords:
/dk/atira/pure/subjectarea/asjc/2900
Subjects:
ID Code:
151448
Deposited By:
Deposited On:
08 Feb 2021 11:35
Refereed?:
Yes
Published?:
Published
Last Modified:
17 Feb 2021 09:18