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.
Peters G, Milnes S, Simpson N, Gedye O, Kakho N, Corke C, et al.
Objective: Describe the association between the implementation of a shared decision-making (SDM) program and documentation of goals of care for critically ill patients with life-limiting illness (LLI).
Methods: A prospective longitudinal cohort study was conducted from 1st January 2015 to 30th September 2020 in an Australian tertiary teaching hospital. Adult patients with LLI admitted to the intensive care unit (ICU) were included. A SDM program consisting of communication training, a new goals of care form, and clinical support was implemented. The primary outcome was the proportion of patients with a documented SDM discussion. Secondary outcomes included patient treatment preferences and hospital utilisation parameters.
Results: A total of 1178 patients with LLI were admitted to the ICU during the study period and included in the study. Following the introduction of an SDM program, the proportion of patients with a documented SDM discussion increased from 22 % at baseline to a peak of 68 % at year five, then 60 % in year six of the study (adjusted odds ratio: 1.49, 95 % confidence interval: 1.38-1.60; p < 0.0001). Patients who had documented SDM were more likely to be older, female, frail, and have a prior advance care plan. SDM discussions resulted in higher rates of documented deterioration treatment preference plan (p < 0.0001), an increased ICU length of stay (3 vs. 2 days, p < 0.0001), referrals to palliative care services (p = 0.002), and a higher mortality rate. Time to death was significantly shorter in decedents with documented SDM compared to those without it (12 vs. 49 days, p < 0.0001).
Conclusion: The implementation of a comprehensive clinical communication training program was associated with increased documentation of shared decision-making discussions for patients in ICU with LLI, which corresponded with changes in patient treatment preferences and healthcare utilisation by decedents. Further research is required to understand the impact of these conversations from the perspective of patients and their families.
Podbury B, Gurgenci T, Huggett G, Greer R, Hardy J, Good P.
Objectives: Patients with advanced cancer experience varying physical and psychological symptoms throughout the course of their illness. Depression, anxiety and stress affect overall well-being. This study investigates the correlation between emotional distress and physical symptoms in a cohort of patients with advanced cancer.
Methods: There were 238 patients included in this study. Data from participants in two medicinal cannabis randomised controlled trials were analysed. Patients were aged over 18 years and had advanced cancer. Edmonton Symptom Assessment System, and Depression, Anxiety and Stress Scale (DASS-21) were assessed for all patients at baseline.
Results: Moderate-severe depression was reported in 29.8% and moderate-severe anxiety was reported in 47.9% of patients. The emotional subscales of DASS-21 (depression, anxiety, stress) correlated with total symptom distress score (p<0.001) and overall well-being (p<0.001). Depression was correlated with physical symptoms of fatigue, nausea, poor appetite and dyspnoea. Anxiety was correlated with fatigue and dyspnoea. Stress was correlated with fatigue, nausea and dyspnoea.
Conclusions: Depression, anxiety and stress were common in this population. The relationship between physical and psychological well-being is complex. A holistic approach to symptom management is required to improve quality of life in patients with advanced cancer.
Schilling C, Bailey C, Merollini K, Giles A, Platts C, Currow DC, et al.
Background: Despite significant advances in the availability and quality of palliative care globally, health economics research to understand the value of palliative care in Australian settings remains scarce. To address knowledge gaps and foster evidence-informed policy, funding and practice, this paper presents a consensus-driven research agenda for the health economics of palliative care in Australia.
Methods: A panel of 27 Australian experts was convened, including health economists, palliative care clinicians/researchers, policy makers/government officials, and representatives from the national peak body for palliative care. Panel members completed a survey, participated in a forum and collectively drafted the research agenda.
Results: The panel recommended 16 health economics research priorities across four key areas: (1) person-centred outcomes; (2) costs; (3) economic evaluation; and (4) data and metrics. Specific priorities included: comprehensively capturing the benefits of palliative care for people with life-limiting illnesses and their informal carers; understanding the diversity of preferences for palliative care across the population; capturing informal caring costs within economic evaluations; embedding economic evaluation within clinical trials and health services studies; and quantifying the extent and location of unmet palliative care needs.
Conclusions: This paper outlines high-priority research actions to generate the economic evidence required for appropriate funding and resource allocation in palliative care. The research agenda serves as a strategic tool to help researchers address gaps without duplicating efforts. By focusing on these priorities, we aim to support the development of more effective, equitable and sustainable palliative care services across Australia.
Damarell R, Nicholls S, Tyndall J, Phelan C.
Background: Research evidence is fundamental to informing clinical decision-making and advancing palliative care practice. Although academic, peer-reviewed journals underpin evidence-based healthcare, they represent only part of the knowledge landscape. Incorporating grey literature from sources outside traditional academic publishing can: provide context, balance and diverse perspectives; address knowledge gaps; and mitigate publication bias. However, its decentralised and dispersed nature can pose challenges for researchers unfamiliar with its scope and diversity.
Aim: To present a flexible framework comprising 12 elements to support researchers in systematically identifying and locating grey literature relevant to palliative care across a broad range of sources. The framework accommodates variation in research focus, available resources, and context. Practical guidance is also provided for reporting grey literature searches with the transparency required in systematic reviews.
Methods: The framework was developed through expert consensus, informed by the authors' collective experience in systematic review methodology, grey literature searching, and information retrieval. It has been iteratively refined through teaching and real-world review projects. Each included source was assessed for its depth and breadth of palliative care content.
Results: The 12-element framework supports palliative care researchers in planning and executing searches across a wide range of fit-for-purpose sources. Practical examples are provided alongside a classification of grey literature source types.
Discussion and conclusion: This framework offers structured yet adaptable guidance to support more consistent grey literature engagement. Persistent challenges include defining search boundaries, managing duplication, record-keeping, and assessing quality. Future research should explore the framework's utility across diverse review types and palliative care research priorities.
Lock K, Goh AMY, Gerber K, Tropea J, Moore K, Lim WK.
Background: This study describes the protocol for a realist process evaluation of IMPART (Improving Palliative Care in Residential Aged Care Using Telehealth), to be trialed through a pragmatic stepped-wedge cluster randomized controlled trial in Australia. IMPART consists of 2 key intervention activities: specialist palliative support provided through telehealth and tailored staff education.
Objective: The aims of the realist process evaluation are to (1) identify and explore the contexts and mechanisms that enable or hinder the implementation of the IMPART intervention, and (2) develop and refine a program theory to determine whether and how successful implementation of IMPART can be facilitated.
Methods: We will conduct this process evaluation in 3 phases, guided by a realist framework. First, to hypothesize an initial program theory, we will review trial documentation and literature to determine how IMPART is expected to work and identify the barriers and facilitators likely to influence implementation. To test this theory in the second phase, a case study methodology will draw on multiple data sources (qualitative and quantitative) from 10 participating residential aged care facilities. These include interviews with staff involved in implementation, data on staff engagement with training, program documentation, activity logs, action plans, and facility information. In the final phase, program theories developed from the case studies will be refined through consultation with the IMPART research team. This will inform the development of a refined program theory that provides key information about what works, for whom, how, and in what circumstances in the implementation of interventions aiming to improve palliative care in residential aged care.
Results: This study was reviewed and approved by the Royal Melbourne Hospital Human Research Ethics Committee. The randomized controlled trial commenced in May 2023, with completion anticipated in November 2025. Funding began in January 2022. Data for the realist process evaluation will be collected between May 2023 and February 2026. As of October 2025, a total of 61 interviews have been completed. Data analysis is ongoing, and a publication describing the results will be prepared in 2026.
Conclusion: Applying a realist framework to explore process outcomes allows for an in-depth inquiry into what works, for whom, how, and in what circumstances in the implementation of complex interventions aiming to improve palliative care in residential aged care. This realist process evaluation has the potential to provide transferable, context-specific findings that can support the development of meaningful policy and accelerate practice change.
Last updated 30 April 2024