Towards integration of palliative care in patients with chronic heart failure and chronic obstructive pulmonary disease: a systematic literature review of European guidelines and pathways

BMC Palliative Care

Research Article

Marlieke van der Eerden¹  Jeroen Hasselaar¹  Marieke Groot¹  Farina Hodiamont²  Lukas Radbruch²  Eduardo Garralda³  Carlos Centeno³  Johan Menten⁴  Karen van Beek⁴  Naouma Siouta⁴  Csilla Busa⁵  Agnes Csikos⁵  Sheila Payne⁶  Sean Hughes⁶  Nancy Preston⁶ 

[1] Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands;Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany;Department of Palliative Medicine, University of Navarra Hospital, Pamplona, Navarra, Spain;Department of Radiation-Oncology and Palliative Medicine, University Hospital Gasthuisberg, Leuven, Belgium;Faculty of Medicine, Institute of Family Medicine, University of Pécs Medical School, Pécs, Hungary;International Observatory on End of Life Care, Division of Health Research Lancaster University, Lancaster, United Kingdom;

关键词: Chronic Obstructive Pulmonary Disease;    Palliative Care;    Chronic Heart Failure;    Advance Care Planning;    Palliative Care Service;   

DOI  :  10.1186/s12904-016-0089-4

 received in 2015-11-02, accepted in 2016-02-03,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundDespite the positive impact of Palliative Care (PC) on the quality of life for patients and their relatives, the implementation of PC in non-cancer health-care delivery in the EU seems scarcely addressed. The aim of this study is to assess guidelines/pathways for integrated PC in patients with advanced Chronic Heart Failure (CHF) and Chronic Obstructive Pulmonary Disease (COPD) in Europe via a systematic literature review.MethodsSearch results were screened by two reviewers. Eligible studies of adult patients with CHF or COPD published between 01/01/1995 and 31/12/2013 in Europe in 6 languages were included. Nine electronic databases were searched, 6 journals were hand-searched and citation tracking was also performed. For the analysis, a narrative synthesis was employed.ResultsThe search strategy revealed 26,256 studies without duplicates. From these, 19 studies were included in the review; 17 guidelines and 2 pathways. 18 out of 19 focused on suffering reduction interventions, 13/19 on a holistic approach and 15/19 on discussions of illness prognosis and limitations. The involvement of a PC team was mentioned in 13/19 studies, the assessment of the patients’ goals of care in 12/19 and the advance care planning in 11/19. Only 4/19 studies elaborated on aspects such as grief and bereavement care, 7/19 on treatment in the last hours of life and 8/19 on the continuation of goal adjustment.ConclusionThe results illustrate that there is a growing awareness for the importance of integrated PC in patients with advanced CHF or COPD. At the same time, however, they signal the need for the development of standardized strategies so that existing barriers are alleviated.

【 授权许可】

CC BY   
© Siouta et al. 2016