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.
Ong XW, Le Couteur DG, Waite LM, Thillainadesan J.
Background: As the aging population grows, the care provided to patients with dementia at the end of life represents a critical area of geriatric and palliative care. This study aimed to describe the care provided to hospitalized patients with dementia who died during their hospital stay.
Methods: A retrospective cohort study was conducted at a teaching hospital in Sydney, Australia. The study included patients with dementia who died during hospitalization. Data were collected on demographic characteristics, clinical management, and documentation of key care processes, including advance care planning, resuscitation orders, and discussions about oral nutrition and hydration.
Results: The study cohort comprised patients with a mean age of 87.2 ± 7.2 years (n = 100), 63% of whom had lived in nursing homes. Geriatric medicine teams cared for a large proportion of patients (63%), and their patients were more likely to be older, from a nursing home, and to die from pneumonia compared to those admitted in palliative care teams. Recommended care processes were implemented in the majority of patients with advance care planning and resuscitation orders being the most frequently documented, and discussions about oral nutrition and hydration the least frequent.
Conclusions: This study highlights the integral role of geriatrics services in providing end-of-life care for hospitalized patients with dementia, and underscore opportunities to enhance the quality and consistency of care for this population.
Davidson PM, Currow DC, Pantilat SZ, Hillman K.
Introduction: Globally health systems are in crisis struggling with upward pressure on demands and without concomitant increases in resources. In high income countries the addition of expensive new technologies is yielding fewer health benefits for every unit of cost and in mid- and lower- income countries the increasing availability of technologies and treatments adds to the upward cost pressures. Many of these stressors are driven by increases in population numbers and the higher proportion of older persons (Beard et al., 2016). Despite the rhetoric of the importance of prevention, almost all expenditure in healthcare is in the acute care sector and most people spending some time in hospital in their last year of life. In the United Kingdom, four fifths of the money spent on healthcare in people’s last year of life was spent on hospital care (Iacobucci, 2025). This also raises the question of the influence of acute care interventions and the role of prevention in older people. The United States (U.S.) spends the most globally on healthcare and in 2023 this was 16. 5 % of its gross domestic product (GDP). Yet the US scored lowest on health outcomes (assessed by access to care, care process, administrative efficiency and equity) compared with Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, and the United Kingdom (Blumenthal et al., 2024). In contrast, Australia scoring number one in this analysis spent 9.8 % of its GDP on healthcare during this same period. This means that how and where money is spent is critical to achieve the best possible outcomes. The financial and resource pressures on health systems are well documented, and we need to acknowledge that health resources are finite (Page et al., 2024). Health systems cannot keep endlessly spending without calibrating to needs and implementing methods for allocating resources ethically and appropriately. The care of the older person at the end-of-life is an important focus for consideration not only in improving health outcomes but reducing costs and promoting the viability of the whole healthcare system. Low value services are those that are ineffective, harmful or provide negligible benefit (Teisberg et al., 2020). It is estimated that 60 % of healthcare is provided in accordance with evidence-based guidelines, 30 % is wasteful or low value, and 10 % inflicts harm. Braithwaite and colleagues have highlighted the need for addressing this 60-30-10 challenge through shifting to learning health systems (Braithwaite et al., 2020). This requires close analyses of current structures, processes and outcomes from a range of stakeholder perspectives and challenging the status quo.
Hardy JR, Greer RM, Pelecanos AM, Huggett GE, Kearney AM, Gurgenci TH, et al.
Purpose: Patients with cancer commonly access cannabis hoping to relieve their symptoms. This study assessed whether a 1:1 10 mg/ml THC:CBD combination oil could improve total symptom burden in patients with advanced cancer over that provided by palliative care alone.
Methods: Participants were randomised to medicinal cannabis (MC) or placebo oil; dose escalated over 14 days according to tolerance and efficacy and continued to day 28. Symptoms assessed using the Edmonton Symptom Assessment Scale (ESAS) were summated to give a total symptom distress score (TSDS). The primary outcome measure was the change from baseline in TSDS at day 14. Secondary outcomes included individual symptom scores, opioid use, participant-selected dose, QoL, psychological symptoms, global impression of change (GIC), and adverse effects.
Results: The pre-planned sample size of 120 at day 14 was reached following the randomisation of 144 patients. Mean (SD) TSDS improved over time in both arms (- 6.30 (12.3) MC, - 6.98 (12.56) placebo, p = 0.76) to day 14 with no difference between arms. A statistically significant improvement in ESAS pain scores in the MC arm (mean (SD) - 1.42 (2.15) MC and - 0.46 (2.83) placebo, p = 0.04) was at the expense of greater psychomimetic toxicity. Improvement in general well-being was greater for the placebo. GIC and the pain component of QoL both favoured MC.
Conclusions: Patients can be informed that a 1:1 THC:CBD combination cannabis oil was no better than palliative care alone in palliating symptoms in patients with advanced cancer. A small benefit in pain control was associated with greater toxicity.
Jaaniste T, Helyar M, Eamens M, Smeal T, Coombs S, Mherekumombe M.
Objectives: Pediatric end-of-life (EOL) care at home is often provided by community palliative care (CPC) nurses who are not specialist pediatric service providers. This study explores the challenges, benefits, and future directions of home-based EOL care as perceived by CPC nurses in New South Wales (NSW), Australia.
Methods: Eleven CPC nurses participated in a semi-structured interview to elicit information about their attitudes and experiences regarding their work in providing community-based EOL care to children. Reflexive thematic analysis was used to explore themes regarding the benefits, challenges and their thoughts on future directions regarding home-based EOL care.
Results: Challenges identified by CPC nurses included resource access, complexity of pediatric, models of care, and family psychological factors. Benefits included patient and family autonomy, home comforts and the nurses' sense of satisfaction. CPC nurses suggested the need for increased education, support and collaboration.
Conclusions: Areas of possible clinical and organizational improvements are discussed, including more pediatric training and experience for CPC nurses.
Tayba L, Cuesta-Briand B, Auret K, Coleman M.
Background: In Australia, substance use disorders disproportionately affect people living in rural and remote areas. Patients with substance use disorders who receive palliative care have complex, often unmet, end-of-life needs. There is scarce evidence on the management of patients with substance use disorders in palliative care, and there is no consensus on the model of care to assist general practitioners manage their patients. This is particularly salient for general practitioners in rural areas, who provide most of the palliative care to their patients.
Methods: This qualitative study explored the experiences of providing palliative care to patients with a substance use disorder among general practitioners in regional Western Australia. Data were collected through semi-structured interviews and subjected to thematic analysis.
Results: A total of 12 interviews were conducted. Three main themes were identified: (1) a value-laden space; (2) substance-specific attitudes and practice; and (3) barriers to managing substance use disorders in palliative care. It was found that General practitioners' personal values shape attitudes towards substance use, and impact on the management of substance use disorders for patients receiving palliative care. Attitudes and palliative care practice vary depending on the type of substance of concern. Perceived barriers to recognition and management of substance use in palliative care included patient, health professional, health system and societal factors.
Conclusions: Early recognition and intervention for people presenting with substance use disorders in palliative care settings may improve patient quality of living and make managing life-limiting illness safer and more effective. In rural settings in Australia, care is often provided by general practitioners yet despite their whole of person approach to medicine and capacity to manage complexity and multimorbidity, challenges persist in optimising the care of substance use disorders in palliative care. This study provides insight into areas for further research, the potential for the development of clinical practice standards and guidelines in this complex area of palliative care.
Last updated 30 April 2024