Stephanie Saunders1, Tieghan Killackey2, Allison Kurahashi1, Chris Walsh3, Kirsten Wentlandt4, Emily Lovrics1, Mary Scott5, Ramona Mahtani1, Mark Bernstein1, Michelle Howard6, Peter Tanuseputro5, Russell Goldman1, Camilla Zimmermann4, Rebecca A Aslakson7, Sarina R Isenberg8. 1. Temmy Latner Centre for Palliative Care and Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada. 2. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada. 3. Library Services, Sinai Health System, Toronto, Ontario, Canada; School of Communications and Nursing, George Brown College, Toronto, Ontario, Canada. 4. Division of Palliative Care, University Health Network, Toronto, Ontario, Canada; Division of Medical Oncology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. 5. Bruyere Research Institute, Ottawa, Ontario, Canada. 6. Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada. 7. Department of Medicine and Anesthesiology, Stanford University, Stanford, California, USA. 8. Temmy Latner Centre for Palliative Care and Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada; Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address: Sarina.isenberg@sinaihealthsystem.ca.
Abstract
CONTEXT: Although the literature on transitions from hospital to the community is extensive, little is known about this experience within the context of palliative care (PC). OBJECTIVE: We conducted a systematic review to investigate the impact of receiving palliative care in hospital on the transition from hospital to the community. METHODS: We systematically searched MEDLINE, Embase, ProQuest, and CINAHL from 1995 until April 10, 2018, and extracted relevant references. Eligible articles were published in English, included adult patients receiving PC as inpatients, and explored transitions from hospital to the community. RESULTS: A total of 1514 studies were identified and eight met inclusion criteria. Studies were published recently (>2012; n = 7, 88%). Specialist PC interventions were delivered by multidisciplinary care teams as part of inpatient PC triggers, discharge planning programs, and transitional care programs. Common outcomes reported with significant findings consisted of length of stay (n = 5), discharge support (n = 5), and hospital readmissions (n = 6) for those who received inpatient PC. Most studies were at high risk of bias. CONCLUSION: Heterogeneity of study designs, outcomes, findings, and poor methodological quality renders it challenging to draw conclusions regarding PC's impact on the transition from hospital to home. Further research should use standardized outcomes with randomized controlled trial and/or propensity matched cohort designs.
CONTEXT: Although the literature on transitions from hospital to the community is extensive, little is known about this experience within the context of palliative care (PC). OBJECTIVE: We conducted a systematic review to investigate the impact of receiving palliative care in hospital on the transition from hospital to the community. METHODS: We systematically searched MEDLINE, Embase, ProQuest, and CINAHL from 1995 until April 10, 2018, and extracted relevant references. Eligible articles were published in English, included adult patients receiving PC as inpatients, and explored transitions from hospital to the community. RESULTS: A total of 1514 studies were identified and eight met inclusion criteria. Studies were published recently (>2012; n = 7, 88%). Specialist PC interventions were delivered by multidisciplinary care teams as part of inpatient PC triggers, discharge planning programs, and transitional care programs. Common outcomes reported with significant findings consisted of length of stay (n = 5), discharge support (n = 5), and hospital readmissions (n = 6) for those who received inpatient PC. Most studies were at high risk of bias. CONCLUSION: Heterogeneity of study designs, outcomes, findings, and poor methodological quality renders it challenging to draw conclusions regarding PC's impact on the transition from hospital to home. Further research should use standardized outcomes with randomized controlled trial and/or propensity matched cohort designs.
Authors: Lotte Verweij; Denise F Spoon; Michel S Terbraak; Patricia Jepma; Ron J G Peters; Wilma J M Scholte Op Reimer; Corine H M Latour; Bianca M Buurman Journal: J Adv Nurs Date: 2021-02-17 Impact factor: 3.187