ArticleBMC geriatrics2025
Implementing a transmural model of early palliative care in advanced dementia: the use of a hybrid effectiveness-implementation study design.
Article in BMC geriatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPeople with dementia receive differential access to palliative care services despite suffering from a significant burden of the disease in the advanced stage. Professional and familial caregivers may not view dementia as a terminal illness and are less likely to engage in end-of-life care discussions. Healthcare providers also face challenges coordinating palliative care in the community for dementia, demonstrating a lack of understanding of the needs of patients living with advanced dementia, and resources available to support them within the community.
aimThe aim of this study is to implement a transmural model of care in a tertiary care setting where patients living with advanced dementia (PLAD) at risk of deterioration in one year are identified early to receive tailored palliative care interventions using a predictive algorithm. METHODS/
designThe updated medical research council (MRC) framework for complex interventions is used to guide the development and implementation of the transmural model which incorporates a predictive algorithm in clinical practice, with interventions tailored for at risk PLAD both within, and beyond the tertiary care setting. The PROgnostic Model for Advanced DEmentia (PRO-MADE) developed to predict one-year all-cause mortality in PLAD presenting to an acute care hospital was embedded into the electronic health records of the tertiary care setting as a mathematical equation. Predictive modeling markup language in the digital records platform is used to calculate the risk score for PLAD by inputting the predictors. The clinical team is alerted of at risk PLAD through timed directive prompts, with advice on management given through tailored care bundles. The study will adopt a mixed methods approach in a Type 1 effectiveness-implementation study design to concurrently study the effectiveness of the transmural model in practice, and the barriers and facilitators to its implementation.
conclusionThe implementation of a transmural model of early palliative care for patients with advanced dementia requires the coordination between clinicians in the tertiary care setting and community, together with health information technologists. This study protocol describes its development and implementation, and the study design to evaluate its outcomes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.