The following lists palliative care research primarily conducted by Australian research groups. The list is based on application of the CareSearch search filter for palliative care to identify articles held within the PubMed database and corresponding to the strongest evidence. Articles have been selected based on relevance and new articles are added on a weekly basis.
Whilst not an exhaustive list, the aim is to keep the community informed by providing a snapshot of recent research findings and planned studies in the Australian setting.
Button E, McCaffrey N, LeBlanc TW, Carter H.
Aim: To investigate whether early referral to specialist palliative care (SPC) is cost-effective compared to standard care for people ≥ 60 years of age with newly diagnosed acute myeloid leukaemia (AML).
Methods: A modelled cost-utility analysis, from an Australian public healthcare system perspective, over a 5-year time horizon. A systematic review of studies reporting health state utility values (HSUVs), or convertible health-related quality of life measures, provided values for the decision tree model. Cost and effectiveness data were sourced from a broad review of the literature. All costs were estimated using 2022 Australian prices. Scenario analyses and sensitivity analyses explored the impact of varying key assumptions on the results. To account for uncertainty in the model, the mean of Monte Carlo simulation with 10,000 iterations, and 95% uncertainty intervals were reported for base case and scenario analyses results.
Results: For the deterministic base case, SPC was associated with mean incremental cost-saving (AUD -$2805) and greater mean incremental quality-adjusted life years (QALYs [0.05]). In probabilistic sensitivity analysis, the probability of SPC being cost-effective or dominant was 57.3%. In scenario analyses, SPC dominated standard care in all eight scenarios. In one-way sensitivity analysis, results were sensitive to utility values in treatment-related health states.
Conclusions: Findings indicate early SPC is likely to be cost-saving and more effective than standard care. Results must be interpreted cautiously given the reliance on assumptions and uncertainty of inputs in the model. However, findings are promising and warrant further research.
Chauhan A, Greenberg S, Jessop S, Huang N, Fifield-Smith H, El-Kabbout N, et al.
Purpose: Collaboration between medical interpreters and clinicians is crucial in conducting advance care planning (ACP) with people from ethnic minority backgrounds affected by cancer who require language support; however, limited opportunities exist that foster this collaboration. We report here the co-design of a program that fosters interprofessional collaboration between interpreters and clinicians in ACP with people from ethnic minority backgrounds affected by cancer.
Method: Adapted experienced-based co-design (EBCD) was conducted. Building upon data collected from interpreters and health care staff with experience of conducting ACP communication with people from ethnic minority backgrounds affected by cancer, a series of three codesign workshops was conducted to propose and design a solution with ten co-design members. Meetings with three external experts provided important implementation considerations for the co-designed solution.
Results: The co-design team drew on available evidence and feasibility challenges to identify approaches to collectively create opportunities for interprofessional collaboration between clinicians and interpreters. This resulted in the co-designed iCanPlan Program which comprises (1) a didactic interprofessional education in ACP, and (2) facilitated feedback for clinicians and interpreters during practice by an attending health care staff member.
Conclusion: The iCanPlan Program is a first of its kind program co-designed with stakeholders to promote collaboration between interpreters and cancer clinicians. Collaboration with local cancer service leaders and staff will be required to implement the program into practice.
Das A, Halpin S, Kondasinghe JS.
Context: Chronic and intractable hiccups are a debilitating symptom in palliative care, yet the evidence for their pharmacological management is sparse and of low certainty, as certain study designs are frequently excluded from traditional systematic reviews.
Objectives: To synthesise all available quantitative and qualitative evidence for the pharmacological management of chronic and intractable hiccups in adults receiving palliative care.
Methods: We conducted a mixed methods systematic review, including a rapid umbrella review, following a registered PROSPERO protocol (CRD42024514442) in accordance to the PRISMA and SWiM guidelines. Seven electronic databases, trial registries and grey literature sources were searched from inception until August 2025 for studies of any design and systematic reviews. Quantitative data on hiccup reduction or cessation following pharmacological use, and qualitative phenomena of interest on patient and clinician experiences were extracted. Studies were critically appraised via JBI and AMSTAR-2 tools, synthesised separately using a convergent segregated approach, and then integrated narratively. This was performed independently by two reviewers.
Results: A total of 88 primary studies (85 quantitative, two qualitative and one mixed methods) and six systematic reviews were included. The quantitative synthesis, comprising 156 patients, identified gabapentin and baclofen as the most frequently reported effective agents, alongside various dopamine antagonists, benzodiazepines, medication rotation, combination therapies and novel approaches. The qualitative synthesis revealed four themes: the profound psychosocial impact of hiccups, perceived treatment ineffectiveness, a disconnect between patient experience and clinical awareness, and a patient preference for symptom management over cure.
Conclusion: The evidence for management of chronic and intractable hiccups in palliative care is of very low certainty and likely subject to significant publication bias. Clinical goals should be reframed from cure to "palliative control", prioritising functional improvement and a reduction in symptom burden.
Grant MP, Philip JAM, Deliens L, Komesaroff PA.
Background: Ethnography has been used to address a broad range of research questions in health care. With ethnographic research methods it is possible to gain access to the complex realities of health care practice as it occurs, through interpreting the nuances of individual and team behaviours, the roles and dynamics of care provision, and the social impacts and influences of illness. The provision of clinical palliative care is complex, involving multidisciplinary collaboration across different health systems, and is subject to a multitude of personal, cultural and environmental influences. This complexity demands creative methodological approaches to research in palliative care, of which ethnography plays an important, if infrequently utilised, role.
Aim: This article aims to explore potential opportunities of ethnographic methods for palliative care research.
Findings: Ethnographic methods focuses on behaviour in the 'natural' setting of participants, to create theoretical descriptions of events, cultures, interactions and experiences. In palliative care these methods may provide nuanced understandings of illness, relationships and teams, communication, medical education, complex care provision, and novel or changing health practices. Of particular importance is the potential of these methods to understand complex practices and processes, and engage with under-represented population groups who may be excluded from interview research.
Conclusion: Ethnography offers important opportunities for future research in palliative care and should be considered as part of the 'research toolbox' to improve understanding of the complex nature of care provision and the experiences of illness and loss.
Reeves SH, Ngu N, Le S, Runacres F.
We read with interest the publication by Al-Moussally et al in the September issue of BMJ Supportive and Palliative Care titled ‘Palliative care in cirrhosis of the liver’.1 This valuable work highlighted the underutilisation of specialist palliative care services in patients with end-stage liver disease (ESLD) despite their high symptom burden. The authors highlighted referral barriers, including misperceptions of palliative care, as well as health resource factors and insurance coverage.
We undertook a retrospective, longitudinal cohort study exploring the frequency and type of palliative care provided to patients attending a decompensated cirrhosis clinic in Australia. Finance is not a barrier to accessing specialist palliative care due to our universal health insurance scheme funded by taxpayers. Our preliminary data complement this article by exploring the non-financial barriers among patients with ESLD ineligible for transplant.
The primary aim of this study was to determine the proportion of patients presenting to an Australian tertiary hospital decompensated cirrhosis clinic with palliative care needs. Secondary outcomes included how many patients were appropriately referred for specialist palliative care review and determined the type of specialist palliative care received.
Last updated 30 April 2024