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.
Toll K, Villis A, Moullin J.
Abstract: Palliative care management in rural and remote areas generally relies on local resources including a primary healthcare professional and a local health facility. Either in the absence of a primary healthcare professional, or in more complex cases, a patient is frequently transferred to a larger rural- or metropolitan-based health facility, away from community and local supports. With increasing challenges in locum availability, healthcare professionals are challenged in looking out for their own wellness needs, often having to choose between taking time-off or staying on duty and available to provide ongoing care for their patients. In this case report, we describe an alternative hybrid model of care which integrates place-based and virtual management, utilising digital health technologies. This approach supported a rural healthcare professional to take leave, by transferring the care and management of a palliative care patient to the WA Country Health Inpatient Telehealth Service, allowing the patient to remain in their local community and die in their place of choice. Access to palliative care is of great importance to quality care and its impacts cannot be overstated for the person with a terminal illness and their family, it is also important to take into consideration the role of the health professional and their well-being.
Satchell E, Gott M, Juhrmann M, Dicker B, Anderson NE.
Background: Ambulance personnel play an important role in supporting families during death, dying, and bereavement. Evidence-based clinical practice guidelines are crucial for ensuring high-quality ambulance care. However, it is unknown what guidance currently informs care of bereaved families. This document analysis examines ambulance guidelines pertaining to family care in out-of-hospital death in Australia and Aotearoa New Zealand.
Methods: Clinical practice guidelines were sourced from all Australian and Aotearoa New Zealand ambulance services. Using qualitative document analysis, guidance addressing family care during death, dying, and bereavement was examined. Analysis was conducted using a customised coding framework informed by the Australian National Consensus Statement: Essential Elements for safe and high-quality end-of-life care.
Results: While most guidelines included essential elements of end-of-life care, there was significant heterogeneity in the scope, detail and nature of guidance. Care instructions varied between services, populations and clinical scenarios. Guidance pertaining to culturally safe care was limited.
Conclusions: Ambulance clinical guidance remains focused on technical skills during resuscitation, death, and dying. More guidance is needed to inform important elements of family care such as communication, family partnership, and cultural safety. Incorporating evidenced-based principles of end-of-life care presents an opportunity to improve ambulance support for bereaved families.
Chauhan A, Sansom-Daly UM, Manias E, Van Poucke M, Sarwar M, Tieu NT, et al.
Purpose: Despite the availability of resources to support advance care planning (ACP) among people from ethnic minority backgrounds, its uptake remains low among these communities presenting an ACP implementation gap. This study was conducted to understand barriers and facilitators in service delivery experienced by healthcare staff and interpreters involved in implementing ACP with people from ethnic minority backgrounds with cancer.
Methods: A qualitative study using focus groups and semi-structured interviews was conducted with eligible healthcare staff and interpreters. Data was analysed employing the Framework Method using the Theoretical Domains Framework to understand ACP implementation factors.
Results: Eight focus groups comprising 28 participants and three individual semi-structured interviews were conducted. Four themes were developed, along with an underpinning theme of interprofessional collaboration between clinicians and interpreters in ACP. The four themes were as follows: (1) skills of the healthcare clinicians and interpreters; (2) knowledge of cultural factors that impact ACP; (3) the care setting and the physical environment for ACP; and (4) availability of resources to support ACP. Opportunities to foster interprofessional collaboration between clinicians and interpreters, such as training in working with each other and briefing and debriefing, were not available.
Conclusions: Shared understanding between interpreters and cancer clinicians about their communication approach and terminologies to use when no direct translation is available may contribute towards increased uptake of ACP. Identification and necessary adaptations of mechanisms that foster interprofessional collaboration in cancer care between clinicians and interpreters in ACP communication with ethnic minority communities will enhance ACP uptake and person-centred care.
Clapham S, Clark K, Draper K, Mastroianni F, Rand J, Redwood L, et al.
Background: The Palliative Care Outcomes Collaboration (PCOC), established in 2005 and funded by the Australian Government, is a national quality improvement initiative that integrates patient outcome measures into routine clinical practice. While PCOC supports services to improve patient care, implementation across diverse clinical settings presents challenges, with variation observed between similarly resourced services. Engaging services in continuous quality improvement proves difficult as the program grows.
Objectives: To identify factors associated with high-performing palliative care services and develop and evaluate an implementation framework and education program that supports continuous quality improvement.
Methods: Patient outcome data and case studies from established PCOC-participating services were analyzed to identify high-performing services and the factors enabling successful integration of outcome measures. Based on the findings, an implementation framework was developed. Improvement trends were assessed in 20 services participating pre-intervention (2016–2018) and 11 services participating post-intervention (2022–2024).
Results: Five key strategies and 25 enabling factors for successful integration were identified including, leadership and governance; education to improve data literacy; infrastructure for the meaningful management of data; and uptake of PCOC in quality systems. The post-intervention services started with higher benchmark performance and showed improvements within 6 months of implementation. Addressing patient’s psychological/spiritual needs continues to be challenging.
Conclusions: Quality improvement involving outcome measurement and benchmarking in palliative care requires education and structured implementation with ongoing feedback. The PCOC initiative demonstrates that improving patient outcomes involves more than collecting and analyzing outcome measures and benchmarking—it requires integrated assessment models, education, and resources to support information-driven quality improvement.
Gebresillassie BM, Attia J, Cavenagh D, Harris ML.
Background and objective: Proactive palliative interventions can improve symptom control and quality of life in individuals with chronic obstructive pulmonary disease (COPD); however, they are often underutilised. This study aimed to develop and validate a prediction model to identify women with COPD in their last year of life to facilitate timely palliative care referrals and interventions.
Methods: Data from 1236 women diagnosed with COPD from the 1921-1926 Australian Longitudinal Study on Women's Health cohort, linked to administrative health records, were analysed. We employed Lasso regression and multivariable logistic regression to select predictors. To assess the predictive performance of the model, we used the area under the receiver operating characteristic (AUROC) curve, calibration plot, and calibration metrics. The Youden index was used to establish the optimal cutoff point for risk classification. The clinical utility of the model was evaluated using decision curve analysis (DCA).
Results: The final model to predict 1-year all-cause mortality included six predictors: smoking status, body mass index, needing regular assistance with daily activities, number of supplied medications, duration of illness, and number of hospital admissions. The model performed well, with AUROC of 0.82 (95% CI: 0.80-0.85) and showed excellent calibration. Using a cutoff of 56.6% predicted risk, the model achieved a sensitivity of 72.3%, specificity of 77.7%, and accuracy of 75.0%. The DCA indicated that the model provided a greater net benefit for clinical decision-making.
Conclusions: Our prediction model for identifying women with COPD who may benefit from palliative care has shown robust predictive performance and can be easily applied, but requires external validation.
Last updated 30 April 2024