Evidence map›Paper›PMID 33727263›Full record

ArticleBMJ open2021

Occurrence and timely management of problems requiring prompt intervention among Indigenous compared with non-Indigenous Australian palliative care patients: a multijurisdictional cohort study.

John A Woods, Judith M Katzenellenbogen, Kevin Murray, Claire E Johnson, Sandra C Thompson

Abstract read
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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.

John A WoodsWestern Australian Centre for Rural Health, School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia john.woods@uwa.edu.au.ORCID http://orcid.org/0000-0003-3006-8500
Judith M KatzenellenbogenSchool of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia.ORCID http://orcid.org/0000-0001-5287-5819
Kevin MurraySchool of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia.ORCID http://orcid.org/0000-0002-8856-6046
Claire E JohnsonThe Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia.ORCID http://orcid.org/0000-0001-9190-8441
Sandra C ThompsonWestern Australian Centre for Rural Health, School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia.ORCID http://orcid.org/0000-0003-0327-7155

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesAnticipation and prompt relief of symptoms among patients with a life-limiting illness is a core element of palliative care. Indigenous Australians commonly encounter cultural barriers in healthcare that may impair outcomes. The Palliative Care Outcomes Collaboration collects patient care data for the purposes of continuous quality improvement and benchmarking, with each recorded care episode divided into phases that reflect a patient's condition. We aimed to investigate differences between Indigenous and non-Indigenous patients in the occurrence and duration of 'unstable' phases (which indicate unanticipated deterioration in a patient's condition or circumstances), and determine attainment of the relevant benchmark (resolution of unstable phases in ≤3 days in 90% of cases) for both groups.

designCohort study.

settingAustralia-wide hospital-based and community-based specialist palliative care (1 January 2010 to 30 June 2015).

participants139 556 (1502 Indigenous and 138 054 non-Indigenous) adult patients. OUTCOME MEASURES: Indigenous and non-Indigenous patients were compared on (1) the risk of a phase being categorised as unstable, (2) the duration of unstable phases, and (3) the risk of unstable phases being prolonged (>3 days). Crude and adjusted estimates were produced from three-level robust Poisson regression and complementary log-log discrete time survival models.

resultsUnstable phases occurred with similar frequency overall among Indigenous and non-Indigenous patients (adjusted relative risks 1.06; 95% CI 1.00 to 1.11; not significant after correction for multiple comparisons). The duration and risk of prolongation of unstable phases were similar in both patient groups, with no significant differences evident among subgroups. The benchmark was not met for either Indigenous or non-Indigenous patients (unstable phase duration >3 days in 24.3% vs 25.5%; p=0.398).

conclusionsDespite well-documented shortcomings of healthcare for Indigenous Australians, there is no clear evidence of greater occurrence or prolongation of unanticipated problems among Indigenous patients accessing specialist palliative care services in hospital or the community.

Indexed as

Health Services, IndigenousPalliative CareAdultAustraliaCohort StudiesHumansadult palliative carepublic healthquality in health care

Identifiers

PMID33727263
PMCPMC7970279

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