Evidence map›Paper›PMID 28438589›Full record

ArticleJournal of pain and symptom management2017

Specialty Palliative Care Consultations for Nursing Home Residents With Dementia.

Susan C Miller, Julie C Lima, Orna Intrator, Edward Martin, Janet Bull, Laura C Hanson

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of pain and symptom management, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 4 pooled it
3.2field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 4 syntheses or guidelines pooled it, 50 citations in OpenAlex.

  1. Pooled it
  2. Timing of Goals of Care Discussions in Nursing Homes: A Systematic Review.Journal of the American Medical Directors Association · 2023
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Trial
  7. Article
  8. Article
  9. Review
  10. Article
  11. Article
  12. Article
  13. 2024 Alzheimer's disease facts and figures.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024
    Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 1 country.

Susan C MillerDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA; Center for Gerontology and Health Care Research, Brown University School of Public Health, Providence, Rhode Island, USA. Electronic address: susan_miller@brown.edu.
Julie C LimaDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA; Center for Gerontology and Health Care Research, Brown University School of Public Health, Providence, Rhode Island, USA.
Orna IntratorDepartment of Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA; Geriatrics and Extended Care Data and Analyses Center, Canandaigua Veterans Administration Medical Center, Canandaigua, New York, USA.
Edward MartinDepartment of Medicine, Brown University, Providence, Rhode Island, USA; Hope Hospice and Palliative Care, Providence, Rhode Island, USA.
Janet BullFour Seasons, Flat Rock, North Carolina, USA.
Laura C HansonDivision of Geriatric Medicine, Center for Aging and Health, Palliative Care Program, University of North Carolina, Chapel Hill, North Carolina, USA.
Rhode Island Department of Health · USBrown University · USFour Seasons · USUniversity of North Carolina at Chapel Hill · USUniversity of Rochester Medical Center · US

Funding

Palliative Care Consultations: An Unstudied Care Model in Nursing HomesR21AG042550 · NIA · BROWN UNIVERSITY · PI MILLER, SUSAN C · 2013 to 2014
$447k
NIA NIH HHS R21 AG042550
6 · The paper itself

Abstract

contextU.S. nursing home (NH) residents with dementia have limited access to specialty palliative care beyond Medicare hospice.

objectivesThe objective of this study was to examine the value of expanded palliative care access for NH residents with moderate-to-very severe dementia.

methodsWe merged palliative care consultation data in 31 NHs in two states to Medicare data to identify residents with consultations, moderate-to-very severe dementia, and deaths in 2006-2010. Initial palliative consultations were identified as occurring later and earlier (1-30 days and 31-180 days before death, respectively). Three controls for each consultation recipient were selected using propensity score matching. Weighted multivariate analyses evaluated the effect of consultations on hospital or acute care use seven and 30 days before death and on (potentially) burdensome transitions (i.e., hospital or hospice admission three days before death or two plus acute care transitions 30 days before death).

resultsWith earlier consultation (vs. no consultation), hospitalization rates in the seven days before death were on average 13.2 percentage points lower (95% confidence interval [CI] -21.8%, -4.7%) and with later consultation 5.9 percentage points lower (95% CI -13.7%, +4.9%). For earlier consultations (vs. no consultations), rates were 18.4 percentage points lower (95% CI -28.5%, -8.4%) for hospitalizations and 11.9 lower (95% CI -20.7%, -3.1%) for emergency room visits 30 days before death; they were 20.2 percentage points lower (95% CI -28.5%, -12.0%) for burdensome transitions.

conclusionConsultations appear to reduce acute care use and (potentially) burdensome transitions for dying residents with dementia. Reductions were greater when consultations were earlier.

Indexed as

Nursing HomesPalliative CareReferral and ConsultationAdultAgedAged, 80 and overDementiaEmergency Medical ServicesFemaleHealth ExpendituresHospitalizationHumansMaleMedicareMental Status and Dementia TestsMiddle AgedburdensomeconsultationshospicehospitalizationsNHPalliative caretransitions

Identifiers

PMID28438589
PMCPMC5663286
OpenAlexW2606316251

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.