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.
Puranam S, Disalvo D, Giannitrapani K, Lorenz K, Mickelsen J, DeNatale M, et al.
Background: In 2021, the Palliative Care - Promoting and Improving Clinical Excellence (PC-PAICE) collaborative was adapted in Australia after an initial run in India. PC-PAICE partners global experts with local palliative care centers to improve care by fostering quality improvement (QI) capacity.
Intervention: PC-PAICE is a guided QI and mentorship curriculum delivered to interdisciplinary teams working on a relevant project, and each team develops salient project measures. The program has been offered to three Australian cohorts and has trained participants to mentor subsequent participants to build local QI capacity.
Outcomes: Qualitative evaluation has shown teams tackled specific and immediate challenges facing their clinics that were not otherwise recognized without increasing overall work burden. Teams have presented their projects at conferences, and a number have published their work in journals.
Conclusions/ lessons learned: PC-PAICE is uniquely suited to improving palliative care via equitable global partnerships among diverse practitioners. Given its promise, the team is planning to implement the model more widely.
Singh GK, Virdun C, Rattray M, Prichard R, Wynne R.
Background: Optimal palliative care requires a correct assessment of needs. Nurses are well-placed to undertake this task, but the effectiveness of nurse-led palliative care needs assessment remains uncertain.
Aim: To evaluate the evidence regarding the impact of nurse-led palliative care needs assessment on adult patients with oncological and non-oncological illnesses quality of life, symptom burden and hospitalisations.
Design: Systematic review. The review was registered on the international Prospective Register of Systematic Reviews (PROSPERO) (registration number CRD42023429259).
Data sources: Databases searched were CINAHL, PubMed, Embase, and MEDLINE from inception to April 2024.
Methods: A systematic review of English language, randomised controlled trials, conducted in May 2023, and updated in April 2024, on the impact of nurse-led palliative care needs assessment was undertaken. Two independent reviewers screened papers, and two reviewers independently conducted data extraction and risk of bias assessment using the Cochrane Risk of Bias 2 tool. The data were analysed using a narrative synthesis approach by combining studies according to the outcomes of interest.
Results: Six trials were included, involving oncological patients (n = 4), non-oncological patients (n = 1) and deceased aged-care residents (n = 1). Two studies had 'low' risk of bias, two had 'some concerns,' and two had 'high concerns.' There was heterogeneity in the needs assessment tools used and the outcome measures assessed. Researchers who conducted a nurse-led and social worker-led trial in non-oncological patients demonstrated statistically significant improvements in patient quality-of-life and symptom burden. Researchers in two trials found no difference, and two others reported statistically non-significant improvements in quality of life and symptom burden. One group of researchers found no difference in hospitalisations at 6 months. No studies evaluated the inpatient length of stay.
Conclusion: There is a paucity of high-quality evidence on the effectiveness of nurse-led palliative care needs assessments. Future researchers must identify what level of needs predicts poor quality of life, assess interventions tailored to local contexts, and determine how best to evaluate their impact using clinically relevant outcome measures.
Wibisono S, Minto K, Lizzio-Wilson M, Thomas EF, Crane M, Molenberghs P, et al.
Abstract: A narrative systematic review was conducted to review studies that examine mental health implications of involvement in assisted-death services among health practitioners. Qualitative and quantitative studies were included to understand health practitioners' attitudes and experiences with assisted dying services, as well as to identify the mental health consequences. We identified 18 articles from 1591 articles drawn from seven major scientific databases (i.e., PubMed, MEDLINE, CINAHL, PsycINFO, Embase, Web of Science, and Scopus). Two raters independently evaluated the exclusion and inclusion decisions of the articles and examined methodological flaws in the selected articles. We found that engagement in assisted death services were not reliably associated with mental health outcomes such as anxiety and moral distress. Both positive and negative outcomes were reported, and psychological outcomes for practitioners were shown to vary based on factors including social support for health practitioners' views; their perceived capacity to care for the patients; and legislation.
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.
Last updated 30 April 2024