Trial reportPalliative medicine2018
Effects of two feedback interventions on end-of-life outcomes in nursing home residents with dementia: A cluster-randomized controlled three-armed trial.
Trial report in Palliative medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 5 of them syntheses that pooled it.
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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.
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.
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Who cites it
14 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Impact of Specialty and Nonspecialty Palliative Care on Quality of Dying With Alzheimer's Disease or Related Dementias: A Systematic Review and Meta-Analysis.Medical care · 2025Pooled it
- Needs-based triggers for timely referral to palliative care for older adults severely affected by noncancer conditions: a systematic review and narrative synthesis.BMC palliative care · 2023Pooled it
- Routine provision of feedback from patient-reported outcome measurements to healthcare providers and patients in clinical practice.The Cochrane database of systematic reviews · 2021Pooled it
- Palliative care interventions in advanced dementia.The Cochrane database of systematic reviews · 2021Pooled it
- A Systematic Review of Nursing Home Palliative Care Interventions: Characteristics and Outcomes.Journal of the American Medical Directors Association · 2020Pooled it
- Assessing and Listening to Individual Goals and Needs (ALIGN) versus enhanced usual care for hospitalized older patients with cancer discharged to skilled nursing facilities: Protocol for a pilot randomized controlled trial.Journal of geriatric oncology · 2026Article
- Preliminary Findings of an Adapted Nurse-Led Palliative Care Intervention.Journal of palliative medicine · 2024Article
- Uncovering Methods and Outcomes of Palliative Care for Geriatric Patients: A Scoping Review.Journal of multidisciplinary healthcare · 2023Article
- Prevalence and Predictors of Symptoms in Persons with Advanced Dementia Living in the Community.Journal of palliative medicine · 2022Article
- Evaluating implementation strategies to support documentation of veterans' care preferences.Health services research · 2022Article
- Trends in quality of care and dying perceived by family caregivers of nursing home residents with dementia 2005-2019.Palliative medicine · 2021Article
- Quality improvement in long-term care settings: a scoping review of effective strategies used in care homes.European geriatric medicine · 2021Article
- Study on effects of care bundles on patients with severe pneumonia complicated with respiratory failure.American journal of translational research · 2021Article
- What enables good end of life care for people with dementia? A multi-method qualitative study with key stakeholders.BMC geriatrics · 2018Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite increased attention for palliative care in dementia, recent studies found burdensome symptoms and unmet family caregiver needs in the last phase of life. Feedback is being used to improve the quality of palliative care, but we do not know how effective it is.
aimTo assess the effect of two feedback strategies on perceived quality of end-of-life care and comfort in dying nursing home residents with dementia.
methodsIn a cluster-randomized controlled trial, the End-of-Life in Dementia-Satisfaction With Care and the End-of-Life in Dementia-Comfort Assessment in Dying scales were completed by bereaved family caregivers of residents with dementia of 18 Dutch nursing homes. Two feedback strategies, generic feedback with mean End-of-Life in Dementia-scores and feedback with individual (patient-specific) End-of-Life in Dementia-scores, were compared to no feedback provided. The intervention groups discussed End-of-Life in Dementia-ratings in team meetings and formulated actions to improve care. Multi-level analyses assessed effects.
resultsA total of 668 families rated the End-of-Life in Dementia-instruments. Compared to no feedback, the generic strategy resulted in lower quality of end-of-life care in unadjusted ( B = -1.65, confidence interval = -3.27; -0.21) and adjusted analyses ( B = -2.41, confidence interval = -4.07; -0.76), while there was no effect on comfort. The patient-specific strategy did not affect the quality of end-of-life care, but it increased comfort in unadjusted analyses (only, B = 2.20, confidence interval = 0.15; 4.39; adjusted: B = 1.88, confidence interval = -0.34; 4.10).
conclusionNeither feedback strategy improved end-of-life outcome. Perhaps, skills to translate the feedback into care improvement actions were insufficient. Feedback with favorable family ratings might even have triggered opposite effects. Trial number: NTR3942.
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