Evidence map›Paper›PMID 39425550›Full record

SynthesisPalliative medicine2025

Self-care towards the end of life: A systematic review and narrative synthesis on access, quality and cost.

Joshua Gallagher, Bárbara Antunes, James Sutton, Isla Kuhn, Michael P Kelly, Robbie Duschinsky, Stephen Barclay

Abstract readSystematic Review
In one paragraph

Synthesis in Palliative medicine, 2025. 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. Observational
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.

Joshua GallagherPrimary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK.ORCID 0000-0003-3014-3865
Bárbara AntunesPrimary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK.ORCID 0000-0003-1655-7391
James SuttonPrimary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK.
Isla KuhnCambridge University Medical Library, Cambridge, UK.
Michael P KellyPrimary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK.
Robbie DuschinskyPrimary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK.
Stephen BarclayPrimary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPolicy and practice encourages patients to engage in self-care, with individual patient management and remote monitoring of disease. Much is known of the moderate stage of chronic disease, without a clear understanding of how self-care applies towards the end of life.

aimTo review the current evidence on practices of self-care in life-limiting conditions and its impacts on healthcare utilisation, quality of life and associated costs.

designWe systematically searched 10 scientific databases (MEDLINE, CINAHL, Embase, PsycINFO, Cochrane Central, Cochrane Database of Systematic Reviews, Scopus, Sociological Abstracts, Social Work Abstracts and Health Management Information Consortium) from inception to October 2023 with citation and hand searching. A narrative synthesis was undertaken, with quality and relevance assessed using Gough's Weight of Evidence framework. Titles and abstracts were independently screened by three researchers.

resultsFindings from 33 studies revealed self-care as increasingly burdensome or unfeasible towards the end of life, with patients delaying use of professional care. Self-care became increasingly burdensome for patients, carers and professionals as illness progressed. Self-monitoring may exacerbate hospitalisations as patients delayed seeking professional help until crises arose. Findings regarding quality were inconclusive, with some evidence suggesting that self-care can decrease care costs.

conclusionsThis review has shown that research on self-care is an evolving area of study, with a current focus on acute care and hospitalisations. Future research should seek to provide a more complete account of the relation between self-care and non-acute care use, and quality, with further efforts to study self-care costs incurred through self-funding.

Indexed as

Self CareTerminal CareAgedAged, 80 and overHealth Services AccessibilityHumansQuality of Health CareQuality of Lifecostcost-effectivenessdigital healthend of lifemedical technologypalliative carequality of lifeSelf-careself-managementself-monitoring

Identifiers

PMID39425550
PMCPMC11673300

What OpenQuestion holds

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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.