Do Community Specialist Palliative Care Services That Provide Home Nursing Increase Rates of Home Death for People With Life-Limiting Illnesses? A Systematic.

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Presentation transcript:

Do Community Specialist Palliative Care Services That Provide Home Nursing Increase Rates of Home Death for People With Life-Limiting Illnesses? A Systematic Review and Meta-Analysis of Comparative Studies Tim Luckett, BSc (Hons), PhD, Patricia M. Davidson, BA, MEd, PhD, Lawrence Lam, BSc (Hons), MAppPsych, MPH, PhD, Jane Phillips, BAppSci, PhD, David C. Currow, MBBS, MPH, Meera Agar, MBBS, MPC Journal of Pain and Symptom Management Volume 45, Issue 2, Pages 279-297 (February 2013) DOI: 10.1016/j.jpainsymman.2012.02.017 Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 1 Flowchart of review selection process. LQ=lower quality of multiple evaluations reported for the same intervention; NC=no comparator that differed on palliative home nursing; NH=not predominantly home care; NN=no home nursing; NO=no outcomes relating to patient days in community vs. institution or place of death (home vs. institution); NP=not exclusively a palliative population; SS=small sample, with death data reported for less than 10 patients per group. Journal of Pain and Symptom Management 2013 45, 279-297DOI: (10.1016/j.jpainsymman.2012.02.017) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 2 Rates of home deaths for SPCSs with home nursing vs. comparators in nine studies enabling 10 comparisons. Note: Moinpour, 1989a: general home and hospice home care delivered by a Medicare-certified home health agency; Moinpour, 1989b: hospice home care only, delivered by a Medicare-certified home health agency. Journal of Pain and Symptom Management 2013 45, 279-297DOI: (10.1016/j.jpainsymman.2012.02.017) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 3 Rates of home deaths for SPCSs with home nursing vs. comparators in two high-quality studies. SPCS=specialist palliative care service. Journal of Pain and Symptom Management 2013 45, 279-297DOI: (10.1016/j.jpainsymman.2012.02.017) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 4 Rates of home deaths for SPCSs with home nursing vs. comparators in two studies where symptoms/quality of life were not significantly inferior. SPCS=specialist palliative care service. Journal of Pain and Symptom Management 2013 45, 279-297DOI: (10.1016/j.jpainsymman.2012.02.017) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 5 Rates of home deaths for SPCSs with home nursing vs. comparators in five studies where costs were not significantly higher. SPCS=specialist palliative care service. Journal of Pain and Symptom Management 2013 45, 279-297DOI: (10.1016/j.jpainsymman.2012.02.017) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions