Evidence map›Paper›PMID 40217504›Full record

ArticleBMC palliative care2025

The implementation of guidelines in palliative care - a scoping review.

Alexandra Ernst, Franziska Schade, Stephanie Stiel, Katharina van Baal, Franziska A Herbst

Abstract readScoping Review
In one paragraph

Article in BMC palliative care, 2025. 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
–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

2 citing papers in PubMed.

  1. Article
  2. 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.

Alexandra ErnstInstitute for General Practice and Palliative Care, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany. Ernst.Alexandra@mh-hannover.de.ORCID http://orcid.org/0009-0000-1313-5674
Franziska SchadeInstitute for General Practice and Palliative Care, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.ORCID http://orcid.org/0000-0003-3158-4259
Stephanie StielInstitute for General Practice and Palliative Care, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.ORCID http://orcid.org/0000-0002-5963-2526
Katharina van BaalInstitute for General Practice and Palliative Care, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.ORCID http://orcid.org/0000-0002-2425-3710
Franziska A HerbstInstitute for General Practice and Palliative Care, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.ORCID http://orcid.org/0000-0003-2602-9277

Funding

Deutsche Krebshilfe 70115061
6 · The paper itself

Abstract

backgroundGuidelines are essential tools for ensuring high-quality healthcare. However, discrepancies exist between their availability and practical implementation. In the context of palliative care, the extent to which guidelines are implemented and the barriers and facilitators that influence this process remain unknown.

aimThe present study aimed at systematically reviewing the international literature on the implementation of palliative care guidelines to evaluate factors that support or hinder implementation of palliative care guidelines globally.

methodA scoping review was conducted following the methodological approach of Arksey and O'Malley (2005). After the formulation of research questions and development of a search string, relevant studies investigating the implementation of guidelines were identified and retrieved from the databases CINAHL, LIVIO, PubMed and Web of Science Core Collection on 4 January 2024. Two researchers independently selected articles for inclusion, employing a blinded process with predefined inclusion and exclusion criteria. The results were subsequently categorised deductively by the same researchers using Petermann's (2014) taxonomy of implementation outcomes. The results were summarised and presented in tabular form.

resultsThe search yielded 2,086 records, of which 1,252 were included in the title and abstract screening. Subsequently, 113 full-text articles were reviewed for eligibility, resulting in 29 articles deemed suitable for the final analysis. Six implementation outcomes were identified in the included literature: (1) acceptability (n = 15 articles), (2) adoption (n = 6 articles), (3) appropriateness (n = 9 articles), (4) feasibility (n = 9 articles), (5) fidelity/adherence (n = 14 articles) and (6) penetration (n = 14 articles). The majority of studies employed quantitative approaches (n = 22) and considered the perspective of healthcare professionals and their opinions regarding guideline implementation in palliative care. Only 4 articles considered patient related outcomes or the perspectives of the family caregivers. Ten articles reported on facilitators and barriers. Facilitators included healthcare professionals' motivation and managerial support, while barriers primarily referred to time constraints and limited knowledge.

conclusionsGuideline implementation in palliative care is highly variable. Future research should aim at comprehensively analysing facilitators of and barriers to this process, considering diverse implementation outcomes. For these evaluations, mixed-method approaches are recommended.

Indexed as

Guideline AdherenceGuidelines as TopicPalliative CareHumansEnd-of-life careGuidelinesHealth services researchImplementationLiterature reviewPalliative care

Identifiers

PMID40217504
PMCPMC11987174

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.