Evidence map›Paper›PMID 35760548›Full record

ArticleBMJ open2022

Comparative end-of-life communication and support in hospitalised decedents before and during the COVID-19 pandemic: a retrospective regional cohort study in Ottawa, Canada.

Peter Lawlor, Henrique Parsons, Samantha Rose Adeli, Ella Besserer, Leila Cohen, Valérie Gratton, Rebekah Murphy, Grace Warmels, Adrianna Bruni, Monisha Kabir and 18 more

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 28% 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

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Review
  3. 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

28 authors at 5 institutions in 1 country.

Peter LawlorDepartment of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada plawlor@bruyere.org.ORCID 0000-0001-7319-1395
Henrique ParsonsOttawa Hospital Research Institute, Ottawa, Ontario, Canada.
Samantha Rose AdeliFaculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Ella BessererDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Leila CohenDivision of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Valérie GrattonDivision of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Rebekah MurphyDivision of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Grace WarmelsOttawa Hospital Research Institute, Ottawa, Ontario, Canada.
Adrianna BruniDivision of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Monisha KabirDepartment of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada.ORCID 0000-0002-4456-7661
Chelsea NoelDepartment of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada.
Brandon HeidingerDepartment of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada.
Koby AndersonDepartment of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada.
Kyle Arsenault-MehtaDepartment of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada.
Krista WoollerOttawa Hospital Research Institute, Ottawa, Ontario, Canada.
Julie LapenskieDepartment of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada.
Colleen WebberDepartment of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada.ORCID 0000-0001-9193-5386
Daniel BedardInstitut du Savoir Montfort, Ottawa, Ontario, Canada.
Paula EnrightOttawa Hospital Research Institute, Ottawa, Ontario, Canada.
Isabelle DesjardinsOttawa Hospital Research Institute, Ottawa, Ontario, Canada.
Khadija BhimjiDivision of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Claire DyasonDivision of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Akshai IyengarDepartment of Medicine, Queensway Carleton Hospital, Ottawa, Ontario, Canada.
Shirley H BushDepartment of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada.ORCID 0000-0001-8907-1283
Sarina IsenbergDepartment of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada.
Peter TanuseputroDepartment of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada.
Brandi Vanderspank-WrightOttawa Hospital Research Institute, Ottawa, Ontario, Canada.
James DownarDepartment of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada.ORCID 0000-0001-7479-1560
University of Ottawa · CABruyère · CAOttawa Hospital · CAInstitut du Savoir Montfort · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare end-of-life in-person family presence, patient-family communication and healthcare team-family communication encounters in hospitalised decedents before and during the COVID-19 pandemic.

designIn a regional multicentre retrospective cohort study, electronic health record data were abstracted for a prepandemic group (pre-COVID) and two intrapandemic (March-August 2020, wave 1) groups, one COVID-19 free (COVID-ve) and one with COVID-19 infection (COVID+ve). Pre-COVID and COVID-ve groups were matched 2:1 (age, sex and care service) with the COVID+ve group.

settingOne quaternary and two tertiary adult, acute care hospitals in Ottawa, Canada.

participantsDecedents (n=425): COVID+ve (n=85), COVID-ve (n=170) and pre-COVID (n=170).

main outcome measuresEnd-of-life (last 48 hours) in-person family presence and virtual (video) patient-family communication, and end-of-life (last 5 days) virtual team-family communication encounter occurrences were examined using logistic regression with ORs and 95% CIs. End-of-life (last 5 days) rates of in-person and telephone team-family communication encounters were examined using mixed-effects negative binomial models with incidence rate ratios (IRRs) and 95% CIs.

resultsEnd-of-life in-person family presence decreased progressively across pre-COVID (90.6%), COVID-ve (79.4%) and COVID+ve (47.1%) groups: adjusted ORs=0.38 (0.2-0.73) and 0.09 (0.04-0.17) for COVID-ve and COVID+ve groups, respectively. COVID-ve and COVID+ve groups had reduced in-person but increased telephone team-family communication encounters: IRRs=0.76 (0.64-0.9) and 0.61 (0.47-0.79) for in-person, and IRRs=2.6 (2.1-3.3) and 4.8 (3.7-6.1) for telephone communications, respectively. Virtual team-family communication encounters occurred in 17/85 (20%) and 10/170 (5.9%) of the COVID+ve and COVID-ve groups, respectively: adjusted OR=3.68 (1.51-8.95).

conclusionsIn hospitalised COVID-19 pandemic wave 1 decedents, in-person family presence and in-person team-family communication encounters decreased at end of life, particularly in the COVID+ve group; virtual modalities were adopted for communication, and telephone use increased in team-family communication encounters. The implications of these communication changes for the patient, family and healthcare team warrant further study.

Indexed as

COVID-19AdultCanadaCohort StudiesCommunicationDeathHumansPandemicsRetrospective Studiesadult intensive & critical careadult palliative careCOVID-19general medicine (see internal medicine)geriatric medicinequality in health care

Identifiers

PMID35760548
PMCPMC9237652
OpenAlexW4283710206

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.