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.
Corfield J, Gooiker H, Benson M, Bhagat S.
Objectives: Assisted dying and palliative care represent distinct approaches to addressing the needs of patients with advanced, progressive, and life-limiting illness. Although 5 years have passed since the Voluntary Assisted Dying (VAD) Act was passed in Victoria (Australia), little is known about the VAD and palliative care interface in clinical practice. This retrospective case series examined patients who requested VAD and received inpatient specialist palliative care (SPC).
Methods: Retrospective case series of patients admitted to a single-site public palliative care unit (PCU) between June 2019 and June 2024, who had enquired about or requested VAD at any point in time.
Results: 6% of patients admitted to the PCU enquired about or requested VAD at any point in time; 2% raised VAD during their PCU admission, while the remaining patients were admitted with existing requests made in other healthcare settings. A small proportion of patients had VAD requests made by caregivers or had statements misinterpreted as VAD requests. Requests for VAD were made to palliative care professionals (50%) across multiple settings where palliative care is delivered. Most patients (44%) did not progress past an initial request for VAD, and 32% made requests in their final 2 weeks of life. Four patients administered the VAD substance and died while in the PCU. In the PCU, patients discussed VAD with their treating team (number of documented conversations ranging from 0 to 25 during admission).
Conclusions: This case series highlights a tangible intersection between SPC and VAD in that patients enquired about and requested VAD to palliative care teams, and in the PCU, they discussed and completed VAD. Implications for SPC will be discussed.
Ee C, Kandagor B, Paterson C, Vuong K.
Purpose: General Practitioners (GPs) play a crucial role across the cancer continuum, from prevention and early detection to end-of-life care. GPs provide comprehensive care that addresses a broad spectrum of health issues rather than a specific disease. Elements such as person-centeredness, continuity of care and whole-person care define the specialty of general practice. Other characteristics, such as expertise in managing uncertainty, undifferentiated illness and complexity, care coordination and teamwork, facilitate its evolution as a specialty.
Procedures: This paper uses the Caring Life-Course Theory as a theoretical framework to discuss the role of GPs in cancer care. We explore the barriers and enablers of providing optimal care in general practice for people diagnosed with cancer on an micro-, meso- and macro-level using the Caring Life-Course Theory.
Findings: The fundamentals of care framework aligns with the key characteristics of general practice namely first contact care, comprehensive care, continuity of care, person-centeredness and whole-person care. General practice is underpinned by a long-term therapeutic partnership with the patient, the ability to meet a range of care needs simultaneously, and an understanding of the context in which care is taking place. GPs provide care across the life course, facilitate self-care, care from others and care for others, assess care needs at transitions during the cancer continuum, and maintain a detailed care biography of the patient.
Conclusions: Adequate funding of longer consultations to facilitate the delivery of complex care, and expansion of multidisciplinary primary care teams, is required to sustain the delivery of quality cancer care in general practice.
Implications for nursing practice: There is significant opportunity to enhance the role of primary care nursing in delivery of cancer care in general practice, but this must be supported by enablers across all levels of care delivery.
George A, Kong A, Sengupta A, Villarosa AR, Patterson Norrie T, Agar M, et al.
Introduction: Oral health problems are prevalent among people receiving palliative care, affecting their quality of life. However, little is known about dental practitioners' perspectives in this setting. Thus, this study aimed to explore the perceptions of public dental practitioners regarding the provision of dental care for people who receive palliative care.
Methods: An exploratory focus group with 21 public dental practitioners, with a mean of 8.24 years of experience, was conducted in a public oral health service in Sydney, Australia. The focus group was transcribed and analysed using thematic analysis.
Results: Three themes were identified: (1) enhancing quality of life in palliative care through improved oral health; (2) navigating the systemic and practical challenges of palliative dental care; (3) competent, collaborative, and optimised: a palliative oral care model. Participants highlighted the importance of oral health to quality of life while receiving palliative care. Nevertheless, there were several systematic and practical challenges to delivering appropriate dental care, which included competing priorities among clients, disconnects and gaps in care coordination with palliative care providers, limited training, and adapting treatment planning during appointments. Participants highlighted the need for a new model of care in the future that improved dental practitioners' competence through comprehensive palliative dental training, included protocols to facilitate interdisciplinary collaboration, and optimised dental treatment planning and appointment scheduling.
Conclusions: Public dental practitioners in this study demonstrated positive attitudes, but systemic barriers and limited training restrict their care provision. A palliative oral health care model for this setting should include palliative dental training, foster interdisciplinary collaboration, and optimise dental treatment planning.
Parker C, Weinkove R, Wei AH, McQuilten ZK.
Purpose: Acute myeloid leukaemia (AML) carries major clinical, economic, and psychosocial burdens. Supportive care is critical to prevent mortality and morbidity and support long-term well-being. Many AML trials focus on treating AML disease, but few prospectively evaluate supportive care measures. This study sought to identify AML supportive care research priorities to inform the design of future AML clinical trials.
Methods: A three-stage online Delphi process was used. Participants (clinicians and people with lived experience) were invited from Australia and New Zealand through the Australasian Leukaemia and Lymphoma Group (ALLG), the Leukaemia Foundation, and professional networks. Round 1 generated supportive care research question, and in round 2, participants rated each question's importance. A priori criteria were applied for a question to continue to round three. Finally, participants ranked their top 10 research questions and the type of research needed to address each question.
Results: A total of 31 participants completed round one, and 22 in rounds two and three. People with lived experience made up 32% of the sample in round one, 45% in round two, and 27% in round three. Round one resulted in 66 research questions across 13 domains. In round two, from the initial 66 questions, 16 (24%) met the criteria to progress to the next round. In the final round, participants agreed on 10 priority research questions.
Conclusion: This Delphi process identified ten supportive care research priorities in AML across many domains, including infection management, bleeding prevention, nutrition, exercise, and frailty assessments. This work, which incorporates people with lived experience, can be used to inform design of future AML trials.
Tran M, Tham KY, Webster S, Troy L, Fermoyle C, Geis CM, et al.
Objectives: To facilitate earlier access to palliative care (PC) for interstitial lung disease (ILD) patients, a combined ILD-PC clinic was launched at Royal Prince Alfred Hospital. We describe referral patterns and clinical practice 16 months post-implementation.
Methods: A review of consecutive patients referred to the ILD-PC clinic was performed. Reasons for referral, PC interventions implemented and clinical outcomes were documented.
Results: 36 patients were referred to the ILD-PC clinic (75±8 years; 57% men). Diagnoses included idiopathic pulmonary fibrosis (49%), unclassifiable ILD (14%), chronic hypersensitivity pneumonitis (14%) and connective tissue disease-associated ILD (11%). Reasons for referral included high symptom burden (91%), advanced disease (66%) and disease progression (49%). PC management strategies encompassed symptom management (60%), referral to community PC services (40%), advance care planning (26%) and the prescription of opioids and benzodiazepines (23%). During the follow-up period, 23% of patients self-reported worsening symptoms, 40% demonstrated lung function decline, 11% died and 6% were listed for lung transplantation.
Conclusions: The ILD-PC clinic incorporates a multidisciplinary, patient-centred approach to ILD care by enabling early access to symptom management, community services and advance care planning.
Last updated 30 April 2024