Universität zu Köln

Gaertner, Jan ORCID: 0000-0002-8824-7117, Siemens, Waldemar, Antes, Gerd, Meerpohl, Joerg J., Xander, Carola, Schwarzer, Guido ORCID: 0000-0001-6214-9087, Stock, Stephanie and Becker, Gerhild ORCID: 0000-0001-9060-0285 (2015). Specialist palliative care services for adults with advanced, incurable illness in hospital, hospice, or community settings-protocol for a systematic review. Syst. Rev., 4. LONDON: BMC. ISSN 2046-4053

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Abstract

Background: Specialist palliative care (SPC)interventions aim to relieve and prevent suffering in the physical, psychological, social, and spiritual domain. Therefore, SPC is carried out by a multi-professional team with different occupations (e.g., physician, nurse, psychologist, and social worker). Remaining skepticism concerning the need for SPC may be based on the scarcity of high-quality evaluations about the external evidence for SPC. Therefore, we will conduct a systematic review according to Cochrane standards to examine the effects of SPC for adults with advanced illness. Methods/design: The comprehensive systematic literature search will include randomized controlled trials (RCTs) and cluster RCTs. We will search the databases MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and PsycINFO. Patients must be adults suffering from life-limiting diseases. Proxy and caregiver outcomes will not be assessed in order to ensure a clear and well-defined research question for this review. Interventions may be in an in-or outpatient setting, e.g., consulting service, palliative care ward, and palliative outpatient clinic. In line with the multi-dimensional scope of palliative care, the primary outcome is quality of life (QoL). Key secondary outcomes are patients' symptom burden, place of death and survival, and health economic aspects. Subgroup analysis will assess results according to cancer type, age, early vs not early SPC, site of care, and setting. Analysis will be performed with the current RevMan software. We will use the Cochrane Collaboration risk of bias assessment tool. The quality of evidence will be judged according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Discussion: The available evidence will be summarized and discussed to provide a basis for decision-making among health care professionals and policy makers. For SPC, we believe that multi-professional care is of utmost importance. Therefore, single-profession interventions such as physician consultations will not be included. Based on the multidimensional scope of palliative care, we chose QoL as the primary outcome, despite an expected heterogeneity among the QoL outcomes. We consider unidimensional endpoints such as pain for the physical domain to be inadequate for capturing the true scope of (S) PC (i.e., QoL) as defined by the World Health Organization.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Gaertner, Jan UNSPECIFIED orcid.org/0000-0002-8824-7117 UNSPECIFIED Siemens, Waldemar UNSPECIFIED UNSPECIFIED UNSPECIFIED Antes, Gerd UNSPECIFIED UNSPECIFIED UNSPECIFIED Meerpohl, Joerg J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Xander, Carola UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwarzer, Guido UNSPECIFIED orcid.org/0000-0001-6214-9087 UNSPECIFIED Stock, Stephanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Becker, Gerhild UNSPECIFIED orcid.org/0000-0001-9060-0285 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-419740
DOI:	10.1186/s13643-015-0121-4
Journal or Publication Title:	Syst. Rev.
Volume:	4
Date:	2015
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	2046-4053
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ADVANCED CANCER; CONSULTATION; QUALITY; DISEASE; PEOPLE; METAANALYSES; ONCOLOGISTS; LIFE; UNIT; END Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/41974