Hospital initiated palliative care interventions for adults with frailty : findings from a systematic review and narrative synthesis.

Sharratt, Phoebe and Zacharias, Antony and Nwosu, Amara and Gadoud, Amy (2024) Hospital initiated palliative care interventions for adults with frailty : findings from a systematic review and narrative synthesis. Age and Ageing, 53 (9): afae190. ISSN 0002-0729

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Abstract

Background Adults with frailty have palliative care needs [1] but have disproportionately less access to palliative care services [2]. Frailty affects ~4000 patients admitted to hospital per day in the UK [3], making the hospital admission a unique opportunity to assess palliative care needs and deliver interventions. Objectives Synthesise the evidence regarding hospital palliative care (HPC) for patients with frailty. Narratively analyse the evidence regarding methods used to identify palliative care needs; types of palliative care interventions studied; and whether HPC improves outcomes. Methods Systematic literature review and narrative synthesis of experimental, observational and systematic review articles investigating palliative care interventions for hospitalised adults aged ≥65 years with frailty. Electronic search of five databases from database inception to 30 January 2023. Included studies analysed using narrative synthesis according to Popay et al [4]. Results 15 465 titles retrieved, 12 included. Three studies detailed how they identified palliative care needs; all three used prognostication e.g. the ‘surprise question’. Most papers (10/12) investigated specialist palliative care interventions. These interventions addressed a wider range of care needs than non-specialist interventions. Evidence suggested an improvement in some symptom burden and healthcare utilisation outcomes following HPC. Conclusion Prognostication was the main method of identifying palliative care needs, rather than individuals’ specific needs. Specialist palliative care interventions were more holistic, indicating that non-specialist palliative care approaches may benefit from specialist team input. Despite suggestions of improvement in some outcomes with palliative care, heterogenous evidence prevented establishment of conclusive effects.

Item Type:
Journal Article
Journal or Publication Title:
Age and Ageing
Uncontrolled Keywords:
Research Output Funding/yes_externally_funded
Subjects:
?? frailtyolder peoplepalliativehospitalsystematic reviewyes - externally fundedgeriatrics and gerontologyageing ??
ID Code:
224188
Deposited By:
Deposited On:
23 Sep 2024 16:00
Refereed?:
Yes
Published?:
Published
Last Modified:
12 Oct 2024 00:28