Evidence map›Paper›PMID 34034585›Full record

ArticlePalliative medicine2021

Understanding and addressing challenges for advance care planning in the COVID-19 pandemic: An analysis of the UK CovPall survey data from specialist palliative care services.

Andy Bradshaw, Lesley Dunleavy, Catherine Walshe, Nancy Preston, Rachel L Cripps, Mevhibe Hocaoglu, Sabrina Bajwah, Matthew Maddocks, Adejoke O Oluyase, Katherine Sleeman and 4 more

Open access · greenAbstract read
PubMed Publisher
In one paragraph

Article in Palliative medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 2 pooled it
10.2field-weighted citation impact, top 1% 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

23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Perspectives of Advance Care Planning for Latinos During COVID-19.The American journal of hospice & palliative care · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 4 institutions in 1 country.

Andy BradshawWolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK.ORCID 0000-0003-1717-1546
Lesley DunleavyInternational Observatory on End of Life Care, Lancaster University, Lancaster, UK.ORCID 0000-0002-5924-8145
Catherine WalsheInternational Observatory on End of Life Care, Lancaster University, Lancaster, UK.ORCID 0000-0002-4531-8608
Nancy PrestonInternational Observatory on End of Life Care, Lancaster University, Lancaster, UK.ORCID 0000-0003-2659-2342
Rachel L CrippsCicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.ORCID 0000-0001-6945-5028
Mevhibe HocaogluCicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.
Sabrina BajwahCicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.ORCID 0000-0001-5338-8107
Matthew MaddocksCicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.ORCID 0000-0002-0189-0952
Adejoke O OluyaseCicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.ORCID 0000-0002-1506-7262
Katherine SleemanCicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.ORCID 0000-0002-9777-4373
Irene J HigginsonCicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.ORCID 0000-0002-3687-1313
Lorna FraserMartin House Research Centre, Department of Health Sciences, University of York, York, UK.ORCID 0000-0002-1360-4191
Fliss MurtaghWolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK.ORCID 0000-0003-1289-3726
CovPall study team
King's College London · GBLancaster University · GBUniversity of Hull · GBUniversity of York · GB

Funding

Medical Research Council MR/V012908/1
6 · The paper itself

Abstract

backgroundSpecialist palliative care services play an important role in conducting advance care planning during COVID-19. Little is known about the challenges to advance care planning in this context, or the changes services made to adapt.

aimDescribe the challenges that UK specialist palliative care services experienced regarding advance care planning during COVID-19 and changes made to support timely conversations.

designOnline survey of UK palliative/hospice services' response to COVID-19. Closed-ended responses are reported descriptively. Open-ended responses were analysed using a thematic Framework approach using the Social Ecological Model to understand challenges. RESPONDENTS: Two hundred and seventy-seven services.

resultsMore direct advance care planning was provided by 38% of services, and 59% provided more support to others. Some challenges to advance care planning pre-dated the pandemic, whilst others were specific to/exacerbated by COVID-19. Challenges are demonstrated through six themes: complex decision making in the face of a new infectious disease; maintaining a personalised approach; COVID-19-specific communication difficulties; workload and pressure; sharing information; and national context of fear and uncertainty. Two themes demonstrate changes made to support: adapting local processes and adapting local structures.

conclusionsProfessionals and healthcare providers need to ensure advance care planning is individualised by tailoring it to the values, priorities, and ethnic/cultural/religious context of each person. Policymakers need to consider how high-quality advance care planning can be resourced as a part of standard healthcare ahead of future pandemic waves. In facilitating this, we provide questions to consider at each level of the Social Ecological Model.

Indexed as

Advance Care PlanningCOVID-19HumansPalliative CarePandemicsSARS-CoV-2United Kingdomadvance care planningcoronavirushospicesPalliative carepandemicssurveys and questionnaires

Identifiers

PMID34034585
OpenAlexW3165519175

What OpenQuestion holds

Textmetadata
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.