Evidence map›Paper›PMID 28655289›Full record

SynthesisPalliative medicine2018

The costs, resource use and cost-effectiveness of Clinical Nurse Specialist-led interventions for patients with palliative care needs: A systematic review of international evidence.

Natalia Salamanca-Balen, Jane Seymour, Glenys Caswell, David Whynes, Angela Tod

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Palliative medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 5 pooled it
–field-weighted citation impact
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

28 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Guideline
  2. Pooled it
  3. Challenges to Systems of Long-Term Care: Mapping of the Central Concepts from an Umbrella Review.International journal of environmental research and public health · 2023
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Trial
  7. Article
  8. Patients' experiences of participating in a nurse-led clinic for bowel dysfunction following rectal cancer: A qualitative interview study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026
    Article
  9. Article
  10. Review
  11. Article
  12. Infective endocarditis: it takes a team.European heart journal · 2025
    Review
  13. Review
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Guiding the Clinical Nurse Specialist role in oncology within Princess Margaret Cancer Centre.Canadian oncology nursing journal = Revue canadienne de nursing oncologique · 2022
    Article
  20. Canadian oncology nursing journal = Revue canadienne de nursing oncologique · 2022
    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

5 authors.

Natalia Salamanca-Balen1 School of Health Sciences, The University of Nottingham, Nottingham, UK.
Jane Seymour2 School of Nursing and Midwifery, The University of Sheffield, Sheffield, UK.
Glenys Caswell1 School of Health Sciences, The University of Nottingham, Nottingham, UK.
David Whynes3 School of Economics, The University of Nottingham, Nottingham, UK.
Angela Tod2 School of Nursing and Midwifery, The University of Sheffield, Sheffield, UK.

Funding

Marie Curie MCCC-RP-15-A18867
6 · The paper itself

Abstract

backgroundPatients with palliative care needs do not access specialist palliative care services according to their needs. Clinical Nurse Specialists working across a variety of fields are playing an increasingly important role in the care of such patients, but there is limited knowledge of the extent to which their interventions are cost-effective.

objectivesTo present results from a systematic review of the international evidence on the costs, resource use and cost-effectiveness of Clinical Nurse Specialist-led interventions for patients with palliative care needs, defined as seriously ill patients and those with advanced disease or frailty who are unlikely to be cured, recover or stabilize.

designSystematic review following PRISMA methodology. DATA SOURCES: Medline, Embase, CINAHL and Cochrane Library up to 2015. Studies focusing on the outcomes of Clinical Nurse Specialist interventions for patients with palliative care needs, and including at least one economic outcome, were considered. The quality of studies was assessed using tools from the Joanna Briggs Institute.

resultsA total of 79 papers were included: 37 randomized controlled trials, 22 quasi-experimental studies, 7 service evaluations and other studies, and 13 economic analyses. The studies included a wide variety of interventions including clinical, support and education, as well as care coordination activities. The quality of the studies varied greatly.

conclusionClinical Nurse Specialist interventions may be effective in reducing specific resource use such as hospitalizations/re-hospitalizations/admissions, length of stay and health care costs. There is mixed evidence regarding their cost-effectiveness. Future studies should ensure that Clinical Nurse Specialists' roles and activities are clearly described and evaluated.

Indexed as

Health Care CostsHealth ResourcesInternationalityNurse CliniciansCost-Benefit AnalysisHumansPalliative Careadvanced diseaseClinical Nurse Specialistcost–benefit analysiscost-effectivenessEconomicsfrail elderlyhealth care costshealth resourcespalliative care

Identifiers

PMID28655289
PMCPMC5788084

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.