Early Integrated Palliative Home Care and Standard Care for End-Stage COPD (EPIC): A Phase II Pilot RCT Testing Feasibility, Acceptability, and Effectiveness

Scheerens, Charlotte; Pype, Peter; Cauwenberg, Jelle Van; Vanbutsele, Gaëlle; Eecloo, Kim; Derom, Eric; Belle, Simon Van; Joos, Guy; Deliëns, Luc; Chambaere, Kenneth

doi:10.1016/j.jpainsymman.2019.09.012

Cited by 26 publications

(45 citation statements)

References 51 publications

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“…All studies took place in western countries, of which most in the USA ( n = 5) and the United Kingdom ( n = 4). Three RCTs, 28 – 30 two non-randomized controlled trials, 31 – 33 seven uncontrolled before-and-after studies, 34 – 41 six qualitative studies, 42 – 47 one non-comparative study, 48 and 10 pilot/feasibility studies 37 , 49 – 57 were included. The study design of one article was unclear.…”

Section: Resultsmentioning

confidence: 99%

“… 58 Two articles reported on the same study and were collated. 32 , 33 Five quantitative studies 30 , 33 , 35 , 41 , 48 and six pilot/feasibility studies 37 , 50 – 52 , 54 , 55 also included qualitative data. Eighteen studies (60%) focused specifically on COPD.…”

Section: Resultsmentioning

confidence: 99%

“…Half of the interventions were developed based on literature according to the description in the article; two were based on specific guidelines. Thirteen of the twenty interventions comprised of longitudinal care in which there was regular contact of a nurse with patients via home visits, 28 , 34 – 36 , 39 , 44 , 55 , 57 outpatient visits 31 , 33 , 47 or a combination of both. 38 Vitacca et al 56 included telemonitoring.…”

Section: Resultsmentioning

confidence: 99%

“…Organization Barrier 33,41,44,48,51,55 Staff were unable to dedicate adequate time to the improvement efforts. 33…”

Section: Provider Time Availablementioning

confidence: 99%

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Effectiveness and implementation of palliative care interventions for patients with chronic obstructive pulmonary disease: A systematic review

et al. 2020

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Background: Although guidelines recommend palliative care for patients with chronic obstructive pulmonary disease, there is little evidence for the effectiveness of palliative care interventions for this patient group specifically. Aim: To describe the characteristics of palliative care interventions for patients with COPD and their informal caregivers and review the available evidence on effectiveness and implementation outcomes. Design: Systematic review and narrative synthesis (PROSPERO CRD42017079962). Data sources: Seven databases were searched for articles reporting on multi-component palliative care interventions for study populations containing ⩾30% patients with COPD. Quantitative as well as qualitative and mixed-method studies were included. Intervention characteristics, effect outcomes, implementation outcomes and barriers and facilitators for successful implementation were extracted and synthesized qualitatively. Results: Thirty-one articles reporting on twenty unique interventions were included. Only four interventions (20%) were evaluated in an adequately powered controlled trial. Most interventions comprised of longitudinal palliative care, including care coordination and comprehensive needs assessments. Results on effectiveness were mixed and inconclusive. The feasibility level varied and was context-dependent. Acceptability of the interventions was high; having someone to call for support and education about breathlessness were most valued characteristics. Most frequently named barriers were uncertainty about the timing of referral due to the unpredictable disease trajectory (referrers), time availability (providers) and accessibility (patients). Conclusion: Little high-quality evidence is yet available on the effectiveness and implementation of palliative care interventions for patients with COPD. There is a need for well-conducted effectiveness studies and adequate process evaluations using standardized methodologies to create higher-level evidence and inform successful implementation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Organization Barrier 33,41,44,48,51,55 Staff were unable to dedicate adequate time to the improvement efforts. 33…”

Section: Provider Time Availablementioning

confidence: 99%

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Effectiveness and implementation of palliative care interventions for patients with chronic obstructive pulmonary disease: A systematic review

et al. 2020

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“…Our aim is to build on the work presented in the European Association for Palliative Care Atlas (Arias-Casais et al, 2019) and the current document on PC by the WHO (World Health Organization, 2019b) via collaboration in the A3 action group on 'Lifespan Health Promotion & Prevention of Age Related Frailty and Disease' of the European Innovation Partnership on Active and Healthy Ageing (EIP/AHA). We will discuss (primarily within an EU context) the enablers, barriers and gaps in shifting PC toward a person-centered public health approach that emphasizes the early detection of PC needs to maintain QOL (Scheerens et al, 2020) and allows the integration of PC into chronic care management. We anticipate that this discourse will stimulate readers to consider new policy and pathways for integrating chronic care management into macro-, meso-and micro-levels of care systems.…”

Section: Introductionmentioning

confidence: 99%

Rethinking palliative care in a public health context: addressing the needs of persons with non-communicable chronic diseases

Tziraki

Grimes

Ventura

et al. 2020

Prim Health Care Res Dev

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Non-communicable chronic diseases (NCCDs) are the main cause of morbidity and mortality globally. Demographic aging has resulted in older populations with more complex healthcare needs. This necessitates a multilevel rethinking of healthcare policies, health education and community support systems with digitalization of technologies playing a central role. The European Innovation Partnership on Active and Healthy Aging (A3) working group focuses on well-being for older adults, with an emphasis on quality of life and healthy aging. A subgroup of A3, including multidisciplinary stakeholders in health care across Europe, focuses on the palliative care (PC) model as a paradigm to be modified to meet the needs of older persons with NCCDs. This development paper delineates the key parameters we identified as critical in creating a public health model of PC directed to the needs of persons with NCCDs. This paradigm shift should affect horizontal components of public health models. Furthermore, our model includes vertical components often neglected, such as nutrition, resilience, well-being and leisure activities. The main enablers identified are information and communication technologies, education and training programs, communities of compassion, twinning activities, promoting research and increasing awareness amongst policymakers. We also identified key ‘bottlenecks’: inequity of access, insufficient research, inadequate development of advance care planning and a lack of co-creation of relevant technologies and shared decision-making. Rethinking PC within a public health context must focus on developing policies, training and technologies to enhance person-centered quality life for those with NCCD, while ensuring that they and those important to them experience death with dignity.

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Proactive Integration of Geriatrics and Palliative Care Principles Into Practice for Chronic Obstructive Pulmonary Disease

2020

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Early Integrated Palliative Home Care and Standard Care for End-Stage COPD (EPIC): A Phase II Pilot RCT Testing Feasibility, Acceptability, and Effectiveness

Cited by 26 publications

References 51 publications

Effectiveness and implementation of palliative care interventions for patients with chronic obstructive pulmonary disease: A systematic review

Effectiveness and implementation of palliative care interventions for patients with chronic obstructive pulmonary disease: A systematic review

Rethinking palliative care in a public health context: addressing the needs of persons with non-communicable chronic diseases

Proactive Integration of Geriatrics and Palliative Care Principles Into Practice for Chronic Obstructive Pulmonary Disease

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