Experiences implementing a 6-month pilot of a 7-day community CNS service in an urban hospice in Scotland

Cook, Audra; Grady, Anna; Milton, Libby

doi:10.12968/ijpn.2012.18.8.407

Cited by 6 publications

(22 citation statements)

References 10 publications

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“…A wide variety of study designs were used, with the most common being qualitative methods used in seven of the papers [32, 35, 36, 38, 41, 42, 50]. Four of the papers were service evaluations [30, 47, 51, 52] and there were three randomised controlled trials [34, 48, 49]. Three of the papers were protocols [29, 33, 45] and three of the papers simply gave a description of the intervention without any identifiable study design [39, 53, 54] which served to address objective 1 of the study (description of current telehealth use).…”

Section: Resultsmentioning

confidence: 99%

Telehealth in palliative care is being described but not evaluated: a systematic review

et al. 2019

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BackgroundTelehealth is growing and its application in palliative care is seen as a solution to pressures on palliative care services. A 2010 UK review reported growing awareness of telehealth in palliative care but a lack of evidence-based research to support its use. The primary aim of this review was to describe the current use of telehealth in palliative care in the UK and evaluate telehealth initiatives against a digital service standard. The secondary aim was to explore whether telehealth results in a reduction in emergency care access.MethodsSystematic review of the literature with thematic synthesis. Records were screened and data extracted by two reviewers. EMBASE, MEDLINE, CINAHL, Psychinfo and Cochrane central register for controlled trials were searched using pre-defined terms. Hand searching of conference literature, thesis databases and citation tracking was also conducted. The protocol for this systematic review was registered with PROSPERO and can be found at http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017080038.ResultsThe search identified 3807 titles and 30 studies were included in the review. Telehealth was used to support patients and carers, electronic record keeping and professional education. Notably, the number of home telemonitoring initiatives for patients had increased from the 2010 review. Despite this variety, many studies were small scale, descriptive and provided little evidence of evaluation of the service. Ten papers were sufficiently detailed to allow appraisal against the digital service standard and only one of these met all of the criteria to some extent. Seven studies made reference to emergency care access.ConclusionsAlthough there is growth of telehealth services, there remains a lack of evaluation and robust study design meaning conclusions regarding the clinical application of telehealth in palliative care cannot be drawn. There is insufficient evidence to appreciate any benefit of telehealth on access to emergency care. Future work is needed to evaluate the use of telehealth in palliative care and improve telehealth design in line with digital service standards.

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Section: Resultsmentioning

confidence: 99%

Telehealth in palliative care is being described but not evaluated: a systematic review

et al. 2019

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“…While the process of designing and implementing the telephone advice line service was described in several studies 34, 37, 39, 40, 43, 44, 47, 50, 51 , PPI or stakeholder consultation was rarely mentioned and only two studies reported involving patients and carers during development and feasibility testing of services 34, 37 . Two further studies mentioned consulting key stakeholders during development but provided no detailed information on who or what this entailed 43, 47 .…”

Section: Resultsmentioning

confidence: 99%

“…In the seven studies that had 24/7 telephone advice lines and reported call data, between 19-69% of calls were received during out-of-hours periods 33, 35, 38, 43, 46, 52, 53 . Of these, most out-of-hours calls (35-78%) were received on weeknights before midnight, though the level of detail in reports differs 34, 36, 37, 39–42, 44, 45, 47–51 .…”

Section: Resultsmentioning

confidence: 99%

A rapid systematic review of the effectiveness of out-of-hours palliative care telephone advice lines for people living at home and their carers

Johansson,

Chambers,

Curtis

et al. 2023

Preprint

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Background: People with palliative and end-of-life care needs in the community and their carers often rely on out-of-hours services to remain at home. Policymakers internationally have recommended implementation of telephone advice lines to ensure 24-hour access to support. However, little is known about their effectiveness. Aim: To review the evidence for the clinical and cost effectiveness of out-of-hours- telephone advice lines for adults with palliative care needs living at home and their carers, and report service characteristics associated with effectiveness. Design: Rapid systematic review, with narrative synthesis (PROSPERO ID: CRD42023400370). Data sources: Three databases (Medline, EMBASE, CINAHL) were searched in February 2023 for studies reporting on telephone advice lines with at least partial out-of-hours availability. Study quality was assessed using the Mixed Methods Appraisal Tool. Results: Twenty-one studies, published 2000-2022, were included. Most studies were observational; none were experimental. Three were comparative, and seven lacked explicit research questions or methods. Results were largely descriptive, focusing on service development and use, and process measures. Patient and carer outcomes were primarily reported qualitatively. Only two studies investigated possible system outcomes, by examining care-seeking behaviour after using telephone advice lines. Conclusion: Existing evidence for the effectiveness of telephone advice lines is limited. The lack of experimental studies evaluating individual or system-level outcomes prevents assessment of the effectiveness/cost-effectiveness of service models. There is a clear need for more rigorous evaluations using consistent reporting, and inclusion of patient and carer perspectives during both development and implementation. Recommendations for future evaluations are provided.

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“…The relative proportion of out-of-hours palliative care research conducted into primary care, specialist palliative care and Emergency Department services point to the research interest and importance of each area to out-of-hours service provision. Whilst some specialist services have been designed to address specific needs of out-of-hours care, 52 , 59 , 83 , 113 primary care services clearly play a major and critical role in coordinating with secondary and tertiary care agencies to ensure continuity of care.…”

Section: Discussionmentioning

confidence: 99%

“…Specialist Palliative Care Service 47,48,68,69,74,80,86,94,[102][103][104][105][106][107]109,110 16 (20.8) Home visit 44,48,74,77,83,91,92,99,100,[102][103][104][105][106]112 15 (19.5) Triage Service (deliver via telephone or face-toface) 47,71,74,86,[91][92][93][102][103][104][105] 11 (14.3) Domiciliary Service 46,47,68,71,74,86,[91][92][93]…”

Section: Types Of Service N (%)mentioning

confidence: 99%

Co-designing Community Out-of-hours Palliative Care Services: A systematic literature search and review

2022

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Background: In order to provide responsive, individualised and personalised care, there is now greater engagement with patients, families and carers in designing health services. Out-of-hours care is an essential component of community palliative care. However, little is known about how patients, families and carers have been involved in the planning and design of these services. Aim: To systematically search and review the research literature that reports on how out-of-hours palliative care services are provided in the community and to identify the extent to which the principles of co-design have been used to inform the planning and design of these services. Design: Systematic literature search and review. Data sources: A systematic search for published research papers from seven databases was conducted in MEDLINE, PsycINFO, Embase, Emcare, PubMed, CINAHL and Web of Science, from January 2010 and December 2021. Reference list searches of included papers were undertaken to source additional relevant literature. A manifest content analysis was used to analyse the data. Results: A total of 77 papers were included. The majority of out-of-hours services in the community were provided by primary care services. The review found little evidence that patients, families or carers were involved in the planning or development of out-of-hours services. Conclusion: Incorporating patients, families and carers priorities and preferences in the planning and designing of out-of-hours palliative care service is needed for service providers to deliver care that is more patient-centred. Adopting the principles of co-design may improve how out-of-hours care scan be delivered.

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Experiences implementing a 6-month pilot of a 7-day community CNS service in an urban hospice in Scotland

Abstract: The pilot demonstrated the need for a CNS service 7 days a week, and the service is now embedded in practice. Seven-day working benefits patients and families while being valued by the professional team.

Cited by 6 publications

References 10 publications

Telehealth in palliative care is being described but not evaluated: a systematic review

Telehealth in palliative care is being described but not evaluated: a systematic review

A rapid systematic review of the effectiveness of out-of-hours palliative care telephone advice lines for people living at home and their carers

Co-designing Community Out-of-hours Palliative Care Services: A systematic literature search and review

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