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Predictors for place of death among children - a systematic review and meta-analyses of recent literature

WOLFF, Sanne Lausen ; CHRISTIANSEN, Christian Fynbo ; NIELSEN, Mette Kjaergaard ; JOHNSEN, Soeren Paaske ; SCHROEDER, Henrik ; NEERGAARD, Mette Asbjoern
European journal of pediatrics, 30/06/2020, Pagination inconnue

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Comparison of end-of-life care in people with chronic obstructive pulmonary disease or lung cancer - a systematic review

BUTLER, Stacey J ; ELLERTON, Lauren ; GERSHON, Andrea S ; GOLDSTEIN, Roger S ; BROOKS, Dina
PALLIATIVE MEDICINE, 02/06/2020, Pagination inconnue

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Unmet device reprogramming needs at the end of life among patients with implantable cardioverter defibrillator - a systematic review and meta-analysis

GONZALEZ-JARAMILLO, Valentina ; SOBANSKI, Piotr ; CALVACHE, Jose A ; ARENAS-OCHOA, Luisa F ; FRANCO, Oscar H ; HUNZIKER, Lukas ; EYCHMÜLLER, Steffen ; MAESSEN, Maud
PALLIATIVE MEDICINE, 26/06/2020, p. 1-11

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Acupuncture for breathlessness in advanced diseases - a systematic review and meta-analysis

VON TROTT, Philipp ; OEI, Shiao Li ; RAMSENTHALER, Christina
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 02/2020, vol.59, n°2, p. 327-338

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End-of-life care provided for cancer patients - a metasynthesis study

GHEZELSEFLI, Zohreh ; AHMADI, Fazlollah ; MOHAMMADI, Eesa
Holistic nursing practice, 07-08/2020, vol.34, n°4, p. 210-220

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A qualitative meta-synthesis investigating the experiences of the patient's family when treatment is withdrawn in the intensive care unit

COVENTRY, Alysia ; FORD, Rosemary ; ROSENBERG, John ; MCINNES, Elizabeth
Journal of advanced nursing, 13/05/2020, Pagination inconnue

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Experiences of nursing students participating in end-of-life education programs - a systematic review and qualitative metasynthesis

RUIZ-PELLON, N. ; SARABIA-COBO, C. ; AMO-SETIEN, F. ; FERNANDEZ-PEÑA, R. ; ABAJAS, R. ; MARTIN, R. ; ORTEGO-MATE, C.
Nurse education today, 19/04/2020, vol.90, Pagination inconnue

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Summarizing the evidence base for palliative oncology care - a critical evaluation of the meta-analyses

ROGERS, James L. ; PERRY, Laura M. ; HOERGER, Michael
Clinical medicine insights. Oncology, 2020, vol.14, p. 1-5

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Impact of socioeconomic status on end-of-life costs - a systematic review and meta-analysis

YU, Caberry W. ; ALAVINIA, S. Mohammad ; ALTER, David A.
BMC palliative care, 12/2020, vol.19, n°1, p. 1-15

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Thème : Santé. Cote : eD01.01.02

FIN VIE ; COUT SANTE ; REVUE SYSTEMATIQUE ; META-ANALYSE

Background: Socioeconomic inequalities in access to, and utilization of medical care have been shown in many jurisdictions. However, the extent to which they exist at end-of-life (EOL) remains unclear.
Methods: Studies in MEDLINE, EMBASE, CINAHL, ProQuest, Web of Science, Web of Knowledge, and OpenGrey databases were searched through December 2019 with hand-searching of in-text citations. No publication date or language limitations were set. Studies assessing SES (e.g. income) in adults, correlated to EOL costs in last year(s) or month(s) of life were selected. Two independent reviewers performed data abstraction and quality assessment, with inconsistencies resolved by consensus.
Results: A total of twenty articles met eligibility criteria. Two meta-analyses were performed on studies that examined total costs in last year of life – the first examined costs without adjustments for confounders (n = 4), the second examined costs that adjusted for confounders, including comorbidities (n = 2). Among studies which did not adjust for comorbidities, SES was positively correlated with EOL costs (standardized mean difference, 0.13 [95% confidence interval, 0.03 to 0.24]). However, among studies adjusting for comorbidities, SES was inversely correlated with EOL expenditures (regression coefficient, -$150.94 [95% confidence interval, -$177.69 to -$124.19], 2015 United States Dollars (USD)). Higher ambulatory care and drug expenditure were consistently found among higher SES patients irrespective of whether or not comorbidity adjustment was employed.
Conclusion: Overall, an inequality leading to higher end-of-life expenditure for higher SES patients existed to varying extents, even within countries providing universal health care, with greatest differences seen for outpatient and prescription drug costs. The magnitude and directionality of the relationship in part depended on whether comorbidity risk-adjustment methodology was employed.

Origine : DOI.org (Crossref

A mixed-methods systematic review and meta-analysis of barriers and facilitators to paediatric symptom management at end of life

GREENFIELD, Katie ; HOLLEY, Simone ; SCHOTH, Daniel E ; HARROP, Emily ; HOWARD, Richard F ; BAYLISS, Julie ; BROOK, Lynda ; JASSAL, Satbir S ; JOHNSON, Margaret ; WONG, Ian ; LIOSSI, Christina
PALLIATIVE MEDICINE, 31/03/2020, Pagination inconnue

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Thème : Age de la vie, situations spécifiques liées à la fin de vie.

PEDIATRIE ; CONTROLE SYMPTOME ; FIN VIE ; REVUE SYSTEMATIQUE ; META-ANALYSE

Background: Symptom management for infants, children and young people at end of life is complex and challenging due to the range of conditions and differing care needs of individuals of different ages. A greater understanding of these challenges could inform the development of effective interventions.
Aim: To investigate the barriers and facilitators experienced by patients, carers and healthcare professionals managing symptoms in infants, children and young people at end of life.
Design: A mixed-methods systematic review and meta-analysis was undertaken (PROSPERO ID: CRD42019124797).
Data sources: The Cochrane Library, PROSPERO, CINAHL, MEDLINE, PsycINFO, Web of Science Core Collection, ProQuest Dissertations & Theses Database, Evidence Search and OpenGrey were electronically searched from the inception of each database for qualitative, quantitative or mixed-methods studies that included data from patients, carers or healthcare professionals referring to barriers or facilitators to paediatric end-of-life symptom management. Studies underwent data extraction, quality appraisal, narrative thematic synthesis and meta-analysis.
Results: A total of 64 studies were included (32 quantitative, 18 qualitative and 14 mixed-methods) of medium-low quality. Themes were generated encompassing barriers/facilitators experienced by carers (treatment efficacy, treatment side effects, healthcare professionals’ attitudes, hospice care, home care, families’ symptom management strategies) and healthcare professionals (medicine access, treatment efficacy, healthcare professionals’ demographics, treatment side effects, specialist support, healthcare professionals’ training, health services delivery, home care). Only one study included patients’ views.
Conclusion: There is a need for effective communication between healthcare professionals and families, more training for healthcare professionals, improved symptom management planning including anticipatory prescribing, and urgent attention paid to the patients’ perspective.

Origine : DOI.org (Crossref

Immediate effect of fan therapy in terminal cancer with dyspnea at rest - a meta-analysis

KAKO, Jun ; KOBAYASHI, Masamitsu ; OOSONO, Yasufumi ; KAJIWARA, Kohei ; MIYASHITA, Mika
The American journal of hospice and palliative care, 04/2020, vol.37, n°4, p. 294-299

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Hispanic hospice utilization - integrative review and meta-analysis

RISING, Margaret L. ; HASSOUNEH, Dena S. ; LUTZ, Kristin F. ; BERRY, Pat ; LEE, Chris S.
Journal of health care for the poor and underserved, 2019, vol.30, n°2, p. 468-494

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Are the MORECare guidelines on reporting of attrition in palliative care research populations appropriate? - a systematic review and meta-analysis of randomised controlled trials

ORIANI, Anna ; DUNLEAVY, Lesley ; SHARPLES, Paul ; PEREZ ALGORTA, Guillermo ; PRESTON, Nancy J.
BMC palliative care, 09/01/2020, vol.19, n°1, p. 1-15

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Optimal dose-fractionation schedule of palliative radiotherapy for patients with bone metastases - a protocol for systematic review and network meta-analysis

TANG, Xiaofang ; HU, Qiancheng ; CHEN, Ye ; WANG, Xin Shelley ; LI, Xiaofen ; CHENG, Ke ; CAO, Dan
BMJ Open, 06/01/2020, vol.10, n°1, p. 1-5

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Palliative care in chronic heart failure - a theoretically guided, qualitative meta-synthesis of decision-making

SINGH, Gursharan K. ; IVYNIAN, Serra E. ; FERGUSON, Caleb ; DAVIDSON, Patricia M. ; NEWTON, Phillip J.
Heart failure reviews, 03/01/2020, Pagination inconnue

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Effectiveness of dignity therapy for patients with advanced cancer - a systematic review and meta-analysis of 10 randomized controlled trials

LI, Yanfei ; LI, Xiuxia ; HOU, Liangying ; CAO, Liujiao ; LIU, Guanghua ; YANG, Kehu
Depression and anxiety, 06/12/2019, Pagination inconnue

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Use of electrochemotherapy in women with vulvar cancer to improve quality-of-life in the palliative setting - a meta-analysis

TRANOULIS, Anastasios ; GEORGIOU, Dimitra ; FOUNTA, Christina ; MEHRA, Gautam ; SAYASNEH, Ahmad ; NATH, Rahul
International journal of gynecological cancer, 03/12/2019, Pagination inconnue

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Thème : Médecine.

CHIMIOTHERAPIE ; CANCER GENITAL ; META-ANALYSE ; DEMARCHE PALLIATIVE ; QUALITE VIE

INTRODUCTION: Electrochemotherapy involves the use of transient tumor permeabilization via electric pulses in combination with low-dose chemotherapeutic agents. It has recently emerged as an alternative treatment modality in vulvar cancer. The aim of this meta-analysis was to ascertain the effectiveness of electrochemotherapy in the context of palliative care.
METHODS: The following databases were searched: MEDLINE, Scopus, and Cochrane Database, to identify all registered articles pertaining to palliative vulvar cancer treatment with electrochemotherapy from inception until August 2019, in line with PRISMA guidelines. A single-proportion meta-analysis was performed for the outcomes of overall response, complete response, partial response, stable disease, and progressive disease raterespectively, using the random-effect model. Sensitivity analysis was performed to address heterogeneity.
RESULTS: Four studies were included totaling 104 women. The studies were of moderate quality. Pooled results from four studies rendered a summary proportion of 78.8% (95% CI 70.4% to 86.1%) for the outcome of overall response. The median age ranged between 68 and 85 years. The sample size per study ranged between eight and 61 women. The tumors' histological types included: squamous-cell carcinoma (96.2%), Paget's disease (2.9%), and malignant melanoma (0.9%). A total of 65 patients (62.5%) presented with a single nodule, whilst 39 patients (37.5%) presented with multiple nodules. Eighty-nine women (85.6%) were previously submitted to other treatment modalities. The overall response rate ranged from 73.2% to 80.9%. The pooled proportion for the outcomes of complete and partial response rate was 48.7% (95% CI 30.74% to 61.5%) and 30.2% (95% CI 21.7% to 39.4%), respectively. The follow-up ranged from 1 to 51 months. No severe adverse effects were reported. The safety profile of electrochemotherapy was favorable.
CONCLUSIONS: Electrochemotherapy is an effective and minimally invasive treatment modality in the palliative care management of patients with vulvar cancer. The effective control of vulvar tumors by electrochemotherapy may contribute to improvement of quality-of-life. In light of the moderate quality of evidence, a multi-center cooperation is warranted to confirm its palliative benefit.

Origine : PubMed

Marital status and risk of physical frailty - a systematic review and meta-analysis

KOJIMA, Gotaro ; WALTERS, Kate ; ILIFFE, Steve ; TANIGUCHI, Yu ; TAMIYA, Nanako
Journal of the American Medical Directors Association, 15/11/2019, Pagination inconnue

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Thème : Age de la vie, situations spécifiques liées à la fin de vie.

REVUE SYSTEMATIQUE ; META-ANALYSE ; MARIAGE ; VULNERABILITE ; PERSONNE AGEE

OBJECTIVES: Evidence on associations between marital status and frailty is limited. The objectives of this study were to perform a systematic review for associations between marital status and physical frailty and to perform a meta-analysis to combine findings.
DESIGN: Systematic review and meta-analysis.
SETTING AND PARTICIPANTS: Community-dwelling older people with mean age =60 years.
METHODS: Systematic literature search using 5 databases was conducted in February 2019 to identify longitudinal and cross-sectional studies examining associations between marital status and Fried's phenotype-based frailty status. Additional studies were searched for by reviewing the reference lists of relevant articles and conducting forward citation tracking of included articles. Odds ratio (OR) of marital status and frailty was pooled using a random-effects meta-analysis. Subgroup analysis and analyses stratified by gender and marital status (married, widowed, divorced or separated, and never married) were completed.
RESULTS: A total of 1565 studies were found, from which 3 studies with longitudinal data and 35 studies with cross-sectional data were included. Although longitudinal studies suggested that married men had lower frailty risks than unmarried men while married women had higher frailty risks than widowed women, meta-analysis was not possible because of different methodologies. Meta-analyses of cross-sectional data from 35 studies including 80,754 individuals showed that unmarried individuals were almost twice more likely to be frail than married individuals (pooled odds ratio = 1.88, 95% confidence interval = 1.70-2.07). A high degree of heterogeneity was observed (I2 = 69%) and was partially explained by reasons for not being married and study location. Stratified analyses showed that pooled risks of frailty in the unmarried compared with the married were not statistically different between women and women (P for difference = .62).
CONCLUSIONS AND IMPLICATIONS: Three and 35 studies, respectively, were found providing longitudinal and cross-sectional data regarding associations between marital status and frailty among community-dwelling older people. A meta-analysis of cross-sectional data showed almost twice higher frailty risk in unmarried individuals compared with married individuals. Marital status should be recognized as an important factor, and more longitudinal studies controlling for potential confounding factors are needed.

Origine : PubMed

The effect of advance care planning on heart failure - a systematic review and meta-analysis

SCHICHTEL, Markus ; WEE, Bee ; PERERA, Rafael ; ONAKPOYA, Igho
Journal of general internal medicine, 12/11/2019, p. 1-11

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Thème : Soins. Cote : eD02.03.00

PROJET SOIN ANTICIPE ; INSUFFISANCE CARDIAQUE ; REVUE SYSTEMATIQUE ; META-ANALYSE

BACKGROUND: Advance care planning is widely advocated to improve outcomes in end-of-life care for patients suffering from heart failure. But until now, there has been no systematic evaluation of the impact of advance care planning (ACP) on clinical outcomes. Our aim was to determine the effect of ACP in heart failure through a meta-analysis of randomized controlled trials (RCTs).
METHODS: We searched CINAHL, Cochrane Central Register of Controlled Trials, Database of Systematic Reviews, Embase, ERIC, Ovid MEDLINE, Science Citation Index and PsycINFO (inception to July 2018). We selected RCTs including adult patients with heart failure treated in a hospital, hospice or community setting. Three reviewers independently screened studies, extracted data, assessed the risk of bias (Cochrane risk of bias tool) and evaluated the quality of evidence (GRADE tool) and analysed interventions according to the Template for Intervention Description and Replication (TIDieR). We calculated standardized mean differences (SMD) in random effects models for pooled effects using the generic inverse variance method.
RESULTS: Fourteen RCTs including 2924 participants met all of the inclusion criteria. There was a moderate effect in favour of ACP for quality of life (SMD, 0.38; 95% CI [0.09 to 0.68]), patients' satisfaction with end-of-life care (SMD, 0.39; 95% CI [0.14 to 0.64]) and the quality of end-of-life communication (SMD, 0.29; 95% CI [0.17 to 0.42]) for patients suffering from heart failure. ACP seemed most effective if it was introduced at significant milestones in a patient's disease trajectory, included family members, involved follow-up appointments and considered ethnic preferences. Several sensitivity analyses confirmed the statistically significant direction of effect. Heterogeneity was mainly due to different study settings, length of follow-up periods and compositions of ACP.
CONCLUSIONS: ACP improved quality of life, patient satisfaction with end-of-life care and the quality of end-of-life communication for patients suffering from heart failure and could be most effective when the right timing, follow-up and involvement of important others was considered.

Origine : PubMed

Fan therapy for the relief of dyspnea in adults with advanced disease and terminal illness - a meta-analysis of randomized controlled trials

YU, Shui ; SUN, Kai ; XING, Xiufang ; ZHONG, Yinbo ; YAN, Xuemei ; QIU, Weidong ; YAN, Min
JOURNAL OF PALLIATIVE MEDICINE, 12/2019, vol.22, n°12, p. 1603-1609

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