Adejoke O Oluyase1, Mevhibe Hocaoglu1, Rachel L Cripps1, Matthew Maddocks1, Catherine Walshe2, Lorna K Fraser3, Nancy Preston2, Lesley Dunleavy2, Andy Bradshaw4, Fliss E M Murtagh5, Sabrina Bajwah6, Katherine E Sleeman6, Irene J Higginson7. 1. Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK. 2. International Observatory on End of Life Care, Division of Health Research, Lancaster University, Lancaster, UK. 3. Health Sciences, University of York, York, North Yorkshire, UK. 4. Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK. 5. Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK; Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK. 6. Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK; King's College Hospital NHS Foundation Trust, Denmark Hill, UK. 7. Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK; King's College Hospital NHS Foundation Trust, Denmark Hill, UK. Electronic address: irene.higginson@kcl.ac.uk.
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 organizations. Multivariable logistic regression identified associations with challenges. Content analysis explored free text responses. RESULTS: A total of 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.
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 organizations. Multivariable logistic regression identified associations with challenges. Content analysis explored free text responses. RESULTS: A total of 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.
Authors: Isabell Klinger; Maria Heckel; Sophie Shahda; Ursula Kriesen; Carolin Schneider; Sandra Kurkowski; Christian Junghanss; Christoph Ostgathe Journal: Palliat Med Date: 2022-05-30 Impact factor: 5.713
Authors: Sean B O'Donnell; Anna E Bone; Anne M Finucane; Jenny McAleese; Irene J Higginson; Stephen Barclay; Katherine E Sleeman; Fliss Em Murtagh Journal: Palliat Med Date: 2021-08-23 Impact factor: 4.762
Authors: Lucy Ellen Selman; Djj Farnell; M Longo; S Goss; K Seddon; A Torrens-Burton; C R Mayland; D Wakefield; B Johnston; A Byrne; E Harrop Journal: Palliat Med Date: 2022-02-17 Impact factor: 4.762
Authors: Eloise Radcliffe; Aysha Khan; David Wright; Richard Berman; Sara Demain; Claire Foster; Susan Restorick-Banks; Alison Richardson; Richard Wagland; Lynn Calman Journal: Palliat Med Date: 2021-10-19 Impact factor: 4.762
Authors: Gehan Soosaipillai; Anjui Wu; Gino M Dettorre; Nikolaos Diamantis; John Chester; Charlotte Moss; Juan Aguilar-Company; Mark Bower; Christopher Ct Sng; Ramon Salazar; Joan Brunet; Eleanor Jones; Ricard Mesia; Amanda Jackson; Uma Mukherjee; Ailsa Sita-Lumsden; Elia Seguí; Diego Ottaviani; Anna Carbó; Sarah Benafif; Rachel Würstlein; Carme Carmona; Neha Chopra; Claudia Andrea Cruz; Judith Swallow; Nadia Saoudi; Eudald Felip; Myria Galazi; Isabel Garcia-Fructuoso; Alvin J X Lee; Thomas Newsom-Davis; Yien Ning Sophia Wong; Anna Sureda; Clara Maluquer; Isabel Ruiz-Camps; Alba Cabirta; Aleix Prat; Angela Loizidou; Alessandra Gennari; Daniela Ferrante; Josep Tabernero; Beth Russell; Mieke Van Hemelrijck; Saoirse Dolly; Nicholas J Hulbert-Williams; David J Pinato Journal: Ther Adv Med Oncol Date: 2021-09-02 Impact factor: 8.168
Authors: Katherine E Sleeman; Rachel L Cripps; Fliss E M Murtagh; Adejoke O Oluyase; Mevhibe B Hocaoglu; Matthew Maddocks; Catherine Walshe; Nancy Preston; Lesley Dunleavy; Andy Bradshaw; Sabrina Bajwah; Irene J Higginson; Lorna K Fraser Journal: J Palliat Med Date: 2021-12-20 Impact factor: 2.947
Authors: Fayolah Richards; Petya Kodjamanova; Xue Chen; Nicole Li; Petar Atanasov; Liga Bennetts; Brandon J Patterson; Behin Yektashenas; Marco Mesa-Frias; Krzysztof Tronczynski; Nasuh Buyukkaramikli; Antoine C El Khoury Journal: Clinicoecon Outcomes Res Date: 2022-04-28
Authors: Andy Bradshaw; Lesley Dunleavy; Ian Garner; Nancy Preston; Sabrina Bajwah; Rachel Cripps; Lorna K Fraser; Matthew Maddocks; Mevhibe Hocaoglu; Fliss Em Murtagh; Adejoke O Oluyase; Katherine E Sleeman; Irene J Higginson; Catherine Walshe Journal: J R Soc Med Date: 2022-02-08 Impact factor: 18.000