Highlighted Reviews

The following selected systematic reviews have been reviewed by the CareSearch team to highlight the relevance of this research to palliative care practice and the Australian context where appropriate.  For the full list of new reviews added to the CareSearch Systematic Review collection visit the Latest Reviews page.

6 November 2019

Does Deprescribing Improve Quality of Life? A Systematic Review of the Literature.

Pruskowski JA, Springer S, Thorpe CT, Klein-Fedyshin M, Handler SM. Does Deprescribing Improve Quality of Life? A Systematic Review of the Literature. Drugs Aging. 2019 Oct 9. doi: 10.1007/s40266-019-00717-1. [Epub ahead of print]
Reducing the number of medications older people with a life-limiting condition are prescribed may be of benefit in harm reduction and cost to the person. Of 13 studies included in this systematic review of deprescribing only two were able to demonstrate improved quality or life, and none showed reduced hospitalisation rates. However, there was considerable study variation in the combination of medications and settings of care. Additionally, the patient needs to be willing to deprescribe the targeted medication and adverse drug withdrawal events likely impact on hospitalisation rates. In terms of practice, it is suggested that successful deprescribing is achieved when targeted to an individual person’s needs and specific medications.

6 November 2019

Does inpatient palliative care consultation impact outcomes following hospital discharge? A narrative systematic review.

Scott M, Shaver N, Lapenskie J, Isenberg SR, Saunders S, Hsu AT, Tanuseputro P. Does inpatient palliative care consultation impact outcomes following hospital discharge? A narrative systematic review. Palliat Med. 2019 Oct 4:269216319870649. doi: 10.1177/0269216319870649. [Epub ahead of print]
Discharge from an acute hospital when you are dying can be difficult. This review of 15 studies found that in-patient palliative care consultation leads to more patients being discharged into the community and reduces readmission rates by 4.5% to 17%. In practice this suggests that effective transitions to a community setting are supported through palliative care consultations including development of discharge plans, identification of goals of care and symptom management advice.

6 November 2019

Comparative Efficacy of Interventions for Aggressive and Agitated Behaviors in Dementia: A Systematic Review and Network Meta-analysis.

Watt JA, Goodarzi Z, Veroniki AA, Nincic V, Khan PA, Ghassemi M, Thompson Y, Tricco AC, Straus SE. Comparative Efficacy of Interventions for Aggressive and Agitated Behaviors in Dementia: A Systematic Review and Network Meta-analysis. Ann Intern Med. 2019 Oct 15. doi: 10.7326/M19-0993. [Epub ahead of print]
Many people with dementia will experience behavioural and psychological symptoms. Based on 163 studies this review ranks non-pharmacological and pharmacological interventions in managing physical and verbal agitation and aggression in people with dementia. From a practice perspective the findings support greater promotion of non-pharmacological interventions. A visual plot of intervention rankings in this article can be used to quickly identify the most appropriate approach for different behaviours. Also highlighted is the importance of multidisciplinary assessment to identify the underlying cause.