The Role of Palliative Care Interventions in Improving End-of-Life Quality: Insights from a Systematic Review.

Abstract

Introduction

Palliative care (PALC) interventions are pivotal in enhancing the quality of life and quality of care (QOC) for patients with terminal illnesses. Assessing their impact across diverse settings is essential for improving patient outcomes and family satisfaction with care (SWC).

This systematic review examined the impact of PALC interventions on end-of-life care outcomes.

Methods:

Articles from PubMed, Web of Science, and Scopus published between 2013-2023 were reviewed. Participants included staff and/or family members of adult individuals who have recently died. Interventions encompassed any PALC intervention in end-of-life care compared to usual care. Outcomes assessed included symptom management/burden, comfort around dying, QOC, and SWC. The risk of bias was evaluated using Cochrane tools.

Results:

Five studies (n=1905 patients) were included reporting deaths occurring either in nursing homes (n=3) or hospital wards (n=2). Some studies showed improved symptom management, particularly for discomfort and anxiety, while others found no significant differences between groups. Variability was noted in comfort around dying, with improvements reported by healthcare professionals but inconsistent support from family assessments. QOC outcomes varied, with some studies indicating improvements while others did not. SWC outcomes were heterogeneous, influenced by acute comorbidities.

Conclusions:

PALC interventions demonstrate potential in enhancing aspects of end-of-life care, though findings are varied. Further research is essential to address methodological limitations and standardize intervention protocols to optimize PALC's impact on patient and family outcomes.