Evidence map›Paper›PMID 28786995›Full record

Trial reportPloS one2017

Effects of facilitated family case conferencing for advanced dementia: A cluster randomised clinical trial.

Meera Agar, Tim Luckett, Georgina Luscombe, Jane Phillips, Elizabeth Beattie, Dimity Pond, Geoffrey Mitchell, Patricia M Davidson, Janet Cook, Deborah Brooks and 3 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 12 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

30 citing papers in PubMed, 12 syntheses or guidelines pooled it.

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  7. Palliative care interventions in advanced dementia.The Cochrane database of systematic reviews · 2021
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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

13 authors.

Meera AgarFaculty of Health, University of Technology Sydney, Ultimo, New South Wales (NSW), Australia.
Tim LuckettFaculty of Health, University of Technology Sydney, Ultimo, New South Wales (NSW), Australia.ORCID http://orcid.org/0000-0001-6121-5409
Georgina LuscombeSydney Medical School, The University of Sydney, Ultimo, NSW, Australia.
Jane PhillipsFaculty of Health, University of Technology Sydney, Ultimo, New South Wales (NSW), Australia.
Elizabeth BeattieSchool of Nursing, Queensland University of Technology, Herston, Queensland (QLD), Australia.
Dimity PondSchool of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia.
Geoffrey MitchellFaculty of Medicine, The University of Queensland, St Lucia, QLD, Australia.
Patricia M DavidsonFaculty of Health, University of Technology Sydney, Ultimo, New South Wales (NSW), Australia.
Janet CookFaculty of Health, University of Technology Sydney, Ultimo, New South Wales (NSW), Australia.
Deborah BrooksSchool of Nursing, Queensland University of Technology, Herston, Queensland (QLD), Australia.
Jennifer HoultramCentre for Health Research and Evaluation (CHERE), Faculty of Business, UTS, Haymarket, NSW, Australia.
Stephen GoodallCentre for Health Research and Evaluation (CHERE), Faculty of Business, UTS, Haymarket, NSW, Australia.
Lynnette ChenowethCentre for Healthy Brain Ageing, University of New South Wales, Randwick, NSW, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPalliative care planning for nursing home residents with advanced dementia is often suboptimal. This study compared effects of facilitated case conferencing (FCC) with usual care (UC) on end-of-life care.

methodsA two arm parallel cluster randomised controlled trial was conducted. The sample included people with advanced dementia from 20 Australian nursing homes and their families and professional caregivers. In each intervention nursing home (n = 10), Palliative Care Planning Coordinators (PCPCs) facilitated family case conferences and trained staff in person-centred palliative care for 16 hours per week over 18 months. The primary outcome was family-rated quality of end-of-life care (End-of-Life Dementia [EOLD] Scales). Secondary outcomes included nurse-rated EOLD scales, resident quality of life (Quality of Life in Late-stage Dementia [QUALID]) and quality of care over the last month of life (pharmacological/non-pharmacological palliative strategies, hospitalization or inappropriate interventions).

resultsTwo-hundred-eighty-six people with advanced dementia took part but only 131 died (64 in UC and 67 in FCC which was fewer than anticipated), rendering the primary analysis under-powered with no group effect seen in EOLD scales. Significant differences in pharmacological (P < 0.01) and non-pharmacological (P < 0.05) palliative management in last month of life were seen. Intercurrent illness was associated with lower family-rated EOLD Satisfaction with Care (coefficient 2.97, P < 0.05) and lower staff-rated EOLD Comfort Assessment with Dying (coefficient 4.37, P < 0.01). Per protocol analyses showed positive relationships between EOLD and staff hours to bed ratios, proportion of residents with dementia and staff attitudes.

conclusionFCC facilitates a palliative approach to care. Future trials of case conferencing should consider outcomes and processes regarding decision making and planning for anticipated events and acute illness.

trial registrationAustralian New Zealand Clinical Trial Registry ACTRN12612001164886.

Indexed as

CaregiversFamilyNursing HomesAgedAged, 80 and overAustraliaDementiaFemaleHealth PersonnelHumansLinear ModelsMaleMiddle AgedPalliative CareQuality of Health CareQuality of Life

Identifiers

PMID28786995
PMCPMC5546584

What OpenQuestion holds

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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.