Haematological malignancy: are patients appropriately referred for specialist palliative and hospice care? A systematic review and meta-analysis of published data
| Autor: | Russell Patmore, Martin R. Howard, Eve Roman, Anne C Garry, Rhiannon Shellens, Debra Howell |
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| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
Palliative care Attitude of Health Personnel MEDLINE Disease Quality of life (healthcare) Cost of Illness Meta-Analysis as Topic medicine Humans Intensive care medicine Referral and Consultation business.industry Palliative Care Standard of Care General Medicine Confidence interval Patient Care Management Anesthesiology and Pain Medicine Hospice Care Meta-analysis Relative risk Hematologic Neoplasms Quality of Life business End-of-life care Specialization |
| Zdroj: | Palliative medicine. 25(6) |
| ISSN: | 1477-030X |
| Popis: | Haematological malignancies are complex diseases, affecting the entire age spectrum, and having marked differences in presentation, treatment, progression and outcome. Patients have a significant symptom burden and despite treatment improvements for some sub-types, many patients die from their disease. We carried out a systematic review and meta-analysis to examine the proportion of patients with haematological malignancies that received any form of specialist palliative or hospice care. Twenty-four studies were identified, nine of which were suitable for inclusion in the meta-analysis. Our review showed that patients with haematological malignancies were far less likely to receive care from specialist palliative or hospice services compared to other cancers (Risk Ratio 0.46, [95% confidence intervals 0.42–0.50]). There are several possible explanations for this finding, including: ongoing management by the haematology team and consequent strong bonds between staff and patients; uncertain transitions to a palliative approach to care; and sudden transitions, leaving little time for palliative input. Further research is needed to explore: transitions to palliative care; potential unmet patient needs; where patients want to be cared for and die; existing practices in the delivery of palliative and end-of-life care; and barriers to specialist palliative care and hospice referral and how these might be overcome. |
| Databáze: | OpenAIRE |
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