Association between palliative care and the rate of advanced care planning: A systematic review.

Association between palliative care and the rate of advanced care planning: A systematic review. Palliat Support Care. 2019 Nov 27;:1-13 Authors: Koffler S, Mintzker Y, Shai A Abstract OBJECTIVE: Advanced care planning (ACP) is central to patients' dignity and autonomy; however, in many countries it is underutilized. Studies that tested the effects of palliative care (PC) often included the rate of documented ACP as a secondary end point. We aimed to assess the contribution of PC to the rate of ACP among terminally ill patients by systematically reviewing relevant clinical trials. METHOD: PUBMED and "Cochrane trials" databases were screened for clinical trials published until October 2017 that compared the addition of PC to standard treatment and that had ACP as a primary or a secondary end point. Studies were assessed for validity by three investigators using the Cochrane Collaboration tool and the ROBINS-I tool for randomized controlled trials (RCTs) and for cohort studies, respectively. RESULTS: Twenty-six trials with 37,924 patients were included. Four were RCTs, nine were cohort studies, and 12 were cross-sectional studies. Randomized trials had the lowest risk of bias. There was a positive correlation between the addition of PC and ACP in 25 studies, among them four randomized trials. SIGNIFICANCE OF RESULTS: In this systematic review, PC was associated with improvement in the rate of ACP. Understanding ...
Source: Palliative and Supportive Care - Category: Palliative Care Authors: Tags: Palliat Support Care Source Type: research