A guide to evaluation research in terminal care programs

Buckingham, Robert W.; Foley, Susan H.

doi:10.1080/07481187808253302

Cited by 12 publications

(19 citation statements)

References 3 publications

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“…Seven studies recruited mainly from departments in general hospitals and four recruited mainly from primary care (including community services and US health management organisations). One study recruited only from an US Veteran Affairs (VA) hospital, with a population of largely male veterans (Hughes 1992 ). Three studies recruited from cancer centres or secondary care professionals (e.g.…”

Section: Resultsmentioning

confidence: 99%

“…Median/mean age ranged from 53 to 77 years, except in Tramarin 1992 (approximate median was 30 years old). Approximately equal numbers of male and female patients were included, except in four studies where between 60% and 69% were women and in four studies where more than 60% were men ( Gómez-Batiste 2010 with 61% male patients, McCorkle 1989 with 63% male patients, Tramarin 1992 with 79% male patients and Hughes 1992 with largely male veterans). Across eight studies, between 12% and 43% of patients lived alone.…”

Section: Resultsmentioning

confidence: 99%

“…Tramarin 1992; Rabow 2004 and Higginson 2009 , respectively); others existed for some time (e.g. the palliative care home support team in McWhinney 1994 existed for 18 months, the hospital-based home care (HBHC) team in Hughes 1992 existed for 13 years).…”

Section: Resultsmentioning

confidence: 99%

“…Only two studies were able to follow-up 80% or more on all outcomes analysed: Higginson 2009 (46/52 patient and caregiver dyads at the end of the study) and Tramarin 1992 (39/42 patients followed-up on quality of life, the only outcome analysed). In seven studies follow-up varied by outcome with some above and others below the 80% threshold required for quality ( Ahlner-Elmqvist 2008 ; Bakitas 2009 ; Brumley 2007 ; Grande 1999 ; Hughes 1992 ; Jordhøy 2000 ; Zimmer 1985 ). For example, in Grande 1999 , although follow-up was high for the primary outcome (death at home known for 95% of participants randomised) only 53% were followed-up on pain (measured via caregivers six weeks after death).…”

Section: Resultsmentioning

confidence: 99%

“…See comments 2497 (6 studies; 4 of high quality; 5 RCTs and 1 CBA) Conflicting 3 RCTs (2 of high quality) found statistically significant positive effects; the other 2 RCTs (bothhigh quality studies in the US) reported no statistically significant differences. Positive effects were related to a hospital-based specialist service in Norway ( Jordhøy 2000 ) and 2 intermediate services in the US (Brumley 2007 ; Hughes 1992 ) Greer 1986 found significant higher satisfaction with care among caregivers in the hospital-based intervention assessed 90-120 days after the patient died CBA: controlled before and after study; CCT: controlled clinical trial; CI: confidence interval; MS: multiple sclerosis; OR: odds ratio; RCT: randomised controlled trial. a Numbers needed to treat to benefit (NNTBs) were calculated for the study population control risk and for three other assumed control risks (ACR).…”

Section: Summary Of Findings For the Main Comparison [Explamentioning

confidence: 99%

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Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers

Gomes

Calanzani

Curiale

et al. 2013

Cochrane Database of Systematic Reviews

497

341

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Background Extensive evidence shows that well over 50% of people prefer to be cared for and to die at home provided circumstances allow choice. Despite best efforts and policies, one-third or less of all deaths take place at home in many countries of the world. Objectives 1. To quantify the effect of home palliative care services for adult patients with advanced illness and their family caregivers on patients' odds of dying at home; 2. to examine the clinical effectiveness of home palliative care services on other outcomes for patients and their caregivers such as symptom control, quality of life, caregiver distress and satisfaction with care; 3. to compare the resource use and costs associated with these services; 4. to critically appraise and summarise the current evidence on cost-effectiveness. Search methods We searched 12 electronic databases up to November 2012. We checked the reference lists of all included studies, 49 relevant systematic reviews, four key textbooks and recent conference abstracts. We contacted 17 experts and researchers for unpublished data. Selection criteria We included randomised controlled trials (RCTs), controlled clinical trials (CCTs), controlled before and after studies (CBAs) and interrupted time series (ITSs) evaluating the impact of home palliative care services on outcomes for adults with advanced illness or their family caregivers, or both. Data collection and analysis One review author assessed the identified titles and abstracts. Two independent reviewers performed assessment of all potentially relevant studies, data extraction and assessment of methodological quality. We carried out meta-analysis where appropriate and calculated numbers needed to treat to benefit (NNTBs) for the primary outcome (death at home). Main results We identified 23 studies (16 RCTs, 6 of high quality), including 37,561 participants and 4042 family caregivers, largely with advanced cancer but also congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), HIV/AIDS and multiple sclerosis (MS), among other conditions. Meta-analysis showed increased odds of dying at home (odds ratio (OR) 2.21, 95% CI 1.31 to 3.71; Z = 2.98, P value = 0.003; Chi 2 = 20.57, degrees of freedom (df) = 6, P value = 0.002; I 2 = 71%; NNTB 5, 95% CI 3 to 14 (seven trials with 1222 participants, three of high quality)). In addition, narrative synthesis showed evidence of small but statistically significant beneficial effects of home palliative care services compared to usual care on reducing symptom burden for patients (three trials, two of high quality, and one CBA with 2107 participants) and of no effect on caregiver grief (three RCTs, two of high quality, and one CBA with 2113 caregivers). Evidence on cost-effectiveness (six studies) is inconclusive. Authors' conclusions ...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Summary Of Findings For the Main Comparison [Explamentioning

confidence: 99%

See 3 more Smart Citations

Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers

Gomes

Calanzani

Curiale

et al. 2013

Cochrane Database of Systematic Reviews

497

341

View full text Add to dashboard Cite

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Dying Right in Theory and Practice

Perkins¹

1985

Arch Intern Med

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Besser als ein Lehrbuch, aber doch kein Ersatz

Lux

2019

Schmerzmed.

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Die methodische Vorgehensweise bei der Erstellung der Leitlinie ist im Leitlinienreport dargelegt. Dieser ist im Internet z. B. auf den Seiten des Leitlinienprogramms Onkologie (https://www.leitlinienprogramm-onkologie.de/leitlinien/palliativmedizin/) und den Seiten der AWMF (www.awmf.org/) frei verfügbar. 2.2.1.Schema der Evidenzgraduierung nach SIGN Zur Klassifikation des Verzerrungsrisikos der identifizierten Studien wurde in dieser Leitlinie das in Tabelle 2 aufgeführte System des Scottish Intercollegiate Guidelines Network (SIGN) verwendet (siehe www.sign.ac.uk/pdf/sign50.pdf). Unter dem in den Empfehlungen angegebenen Level of Evidence nach SIGN wird ein Body of Evidence verstanden, der die gesamte identifizierte Evidenz zusammenfasst. Deshalb ist auch der Level of Evidence einer Empfehlung, deren Evidenzgrundlage auf einem Systematic Review basiert, der Body of Evidence der in diesem Review eingeschlossenen Primärstudien. Dieser Body of Evidence kann vom Level of Evidence des Systematic Reviews selbst (in den Evidenztabellen angegeben) abweichen. Die Qualität des Systematic Reviews kann nämlich hoch sein, während die Qualität der eingeschlossenen Studien, die sich im Body of Evidence widerspiegelt, niedrig ist. Tabelle 2: Schema der Evidenzgraduierung nach SIGN Grad Beschreibung 1++ Qualitativ hochwertige Metaanalysen, Systematische Übersichten von RCTs oder RCTs mit sehr geringem Risiko systematischer Fehler (Bias) 1+ Gut durchgeführte Metaanalysen, Systematische Übersichten von RCTs oder RCTs mit geringem Risiko systematischer Fehler (Bias) 1-Metaanalysen, Systematische Übersichten von RCTs oder RCTs mit hohem Risiko systematischer Fehler (Bias) 2++ Qualitativ hochwertige systematische Übersichten von Fall-Kontroll-oder Kohortenstudien oder Qualitativ hochwertige Fall-Kontroll-oder Kohortenstudien mit sehr niedrigem Risiko systematischer Verzerrungen (Confounding, Bias, "Chance") und hoher Wahrscheinlichkeit, dass die Beziehung ursächlich ist 2+ Gut durchgeführte Fall-Kontroll-Studien oder Kohortenstudien mit niedrigem Risiko systematischer Verzerrungen (Confounding, Bias, "Chance") und moderater Wahrscheinlichkeit, dass die Beziehung ursächlich ist 2-Fall-Kontroll-Studien oder Kohortenstudien mit einem hohen Risiko systematischer Verzerrungen (Confounding, Bias, "Chance") und signifikantem Risiko, dass die Beziehung nicht ursächlich ist 3 Nicht-analytische Studien, z. B. Fallberichte, Fallserien 4 Expertenmeinung 2.2 Grundlagen der Methodik

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A guide to evaluation research in terminal care programs

Cited by 12 publications

References 3 publications

Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers

Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers

Dying Right in Theory and Practice

Besser als ein Lehrbuch, aber doch kein Ersatz

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