Evidence map›Paper›PMID 37533107›Full record

ArticleBMC palliative care2023

More older adults died at their preferred place after implementation of a transmural care pathway for older adults at the end of life: a before-after study.

Iris van Doorne, Marike A de Meij, Juliette L Parlevliet, Vera M W van Schie, Dick L Willems, Bianca M Buurman, Marjon van Rijn

Open access · goldAbstract read
In one paragraph

Article in BMC palliative care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.4field-weighted citation impact, top 18% 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

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
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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

7 authors at 4 institutions in 1 country.

Iris van DoorneDepartment of Internal Medicine, Section of Geriatric Medicine, Amsterdam University Medical Center, University of Amsterdam, Room D3-335, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands. i.vandoorne@amsterdamumc.nl.
Marike A de MeijPalliative and Supportive Care Team, Oncology Center Amsterdam, OLVG, Oosterpark 9, Amsterdam, The Netherlands.
Juliette L ParlevlietDepartment of Internal Medicine, Section of Geriatric Medicine, Amsterdam University Medical Center, University of Amsterdam, Room D3-335, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
Vera M W van SchieDepartment of Internal Medicine, Section of Geriatric Medicine, Amsterdam University Medical Center, University of Amsterdam, Room D3-335, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
Dick L WillemsGeneral Practice, Section of Medical Ethics, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
Bianca M BuurmanDepartment of Internal Medicine, Section of Geriatric Medicine, Amsterdam University Medical Center, University of Amsterdam, Room D3-335, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
Marjon van RijnDepartment of Internal Medicine, Section of Geriatric Medicine, Amsterdam University Medical Center, University of Amsterdam, Room D3-335, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
GGD Amsterdam · NLUniversity of Amsterdam · NLAmsterdam University Medical Centers · NLVrije Universiteit Amsterdam · NL

Funding

ZonMw 844001103
6 · The paper itself

Abstract

backgroundTo improve transmural palliative care for older adults acutely admitted to hospital, the PalliSupport intervention, comprising an educational programme and transmural palliative care pathway, was developed. This care pathway involves timely identification of palliative care needs, advance care planning, multidisciplinary team meetings, warm handover, and follow-up home visits. With this study, we evaluate changes in patient-related outcomes and transmural collaboration after implementation of the care pathway.

methodsWe conducted a before-after study, in which we compared 1) unplanned hospital admission and death at place of preference and 2) transmural collaboration before implementation, up to six months, and six to 18 months after implementation. Data from palliative care team consultations were collected between February 2017 and February 2020 in a teaching hospital in the Netherlands.

resultsThe palliative care team held 711 first-time consultations. The number of consultation, as well as the number of consultations for patients with non-malignant diseases, and consultations for advance care planning increased after implementation. The implementation of the pathway had no statistically significant effect on unplanned hospitalization but associated positively with death at place of preference more than six months after implementation (during/shortly after adjusted OR: 2.12; 95% CI: 0.84-5.35; p-value: 0.11, long term after adjusted OR: 3.14; 95% CI: 1.49-6.62; p-value: 0.003). Effects on transmural collaboration showed that there were more warm handovers during/shortly after implementation, but not on long term. Primary care professionals attended multidisciplinary team meetings more often during and shortly after implementation, but did not more than six months after implementation.

conclusionsThe pathway did not affect unplanned hospital admissions, but more patients died at their place of preference after implementation. Implementation of the pathway increased attention to- and awareness for in-hospital palliative care, but did not improve transmural collaboration on long-term. For some patients, the hospital admissions might helped in facilitating death at place of preference.

Indexed as

Critical PathwaysTerminal CareAgedControlled Before-After StudiesDeathHospitalizationHumansPalliative CareBefore-after studyPalliative careTransmural palliative care pathway

Identifiers

PMID37533107
PMCPMC10394846
OpenAlexW4385496481

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.