ArticleBMC palliative care2025
'People ring because they're frightened': findings from a realist evaluation on the impact of timely responsive care at home at the end of life.
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 1 paper, 1 of them a synthesis that pooled 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.
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, 1 synthesis or guideline pooled it.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundRapid response services (RRS) support patients who wish to die at home, providing flexible, timely, and specialist care. These services are regionally variable yet are valued by patients and caregivers in often uncertain end-of-life situations. Research on their effectiveness and implementation to date is limited. This study explores how RRS are experienced in practice and identifies key contexts and mechanisms underpinning their impact.
objectivesThis study aimed to understand how different service models of RRS function, who they work for, how and why. By exploring patient, caregiver, and staff perspectives, we sought to refine programme theories and provide evidence-based recommendations for service improvement and policy development.
designA realist evaluation approach was used to examine how, why, and in what contexts RRS provide end-of-life care. Through iterative theory development and refinement, we identified key generative mechanisms and the contexts in which they trigger outcomes.
methodsQualitative data were collected via realist theory driven semi-structured focus groups and interviews with 36 participants across two sites, each operating a distinct RRS model. Data were analysed using a retroductive context-mechanism-outcome (CMO) framework and informed by Transitions Theory.
resultsSix programme theories were developed, highlighting the central role of continuity of care in enabling positive end-of-life experiences. A sense of 'being known' by RRS staff facilitated smooth transitions, reduced distress, and fostered trust. Timely, responsive care, particularly at night, was valued, whereas gatekeeping, fragmented service models, and inequities in access (especially for non-cancer patients) created barriers.
conclusionsPatients and caregivers valued holistic, relationship-centred care that provided emotional security alongside practical support. However, service inconsistencies, late transitions into palliative care, and systemic inequities limit accessibility. Findings highlight the need for early engagement, integrated service models, and 24/7 specialist care, ensuring greater continuity and equity in home-based end-of-life care.
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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.