A Systematic Review of Nursing Home Palliative Care Interventions: Characteristics and Outcomes.
Joan G Carpenter, Karissa Lam, Ashley Z Ritter and 1 others
PMID 31924556WHAT IT FOUND
Nursing home palliative care interventions sometimes improved care processes, but evidence for resident symptoms, acute care use, advance care planning, family ratings, quality of life, and costs was mixed or lacking.
Key findings
01Six studies reported positive changes in nursing home palliative care practices.
02Pain and symptom findings were uneven: two studies improved assessment and management processes, but four interventions did not improve resident pain ratings.
03Acute care outcomes were inconsistent: five studies found reductions in emergency department visits, rehospitalizations, acute care admissions, days in acute care, or in-hospital death, while four showed no significant effect on some of these outcomes.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Most included trials had high or unclear risk of bias, so results need cautious interpretation. Trial designs were heterogeneous, including historical controls and non-randomized comparisons, which limits confidence in the findings. Interventions were multicomponent, so the review cannot identify which parts were effective. Symptom outcomes in dementia relied partly on surrogate report and records, which may be inaccurate. The review excluded single-component interventions, so potentially useful simpler programs may be missing. The risk of bias assessment was subjective and may not fit all trial designs.
Declared interests
The authors declared no conflicts of interest. The article is labelled as receiving NIH extramural research support.
The easy way to misread this
Do not conclude that nursing home palliative care interventions reduce resident pain or improve family satisfaction. The review mostly found changes in care processes, while symptom and family-rated outcomes were mixed or not improved.