The effectiveness of community-based palliative care programme components: a systematic review

Area of Science:

• Palliative Care Research
• Health Services Research
• Evidence Synthesis

Background:

• Community-based palliative care (CBPC) programs demonstrate cost-effective improvements in patient outcomes and caregiver experiences.
• However, specific components driving these positive outcomes remain underexplored.

Approach:

• A systematic mixed-methods review was conducted, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Searches across four databases (CINAHL, Web of Science, ProQuest, PubMed) identified 1,674 articles, with 57 meeting inclusion criteria for analysis.
• Included studies evaluated single, specific components of CBPC programs using quantitative, qualitative, or mixed-methods designs.

Key Points:

• Standardized interdisciplinary patient meetings, volunteer engagement, and early intervention were identified as significant contributors to CBPC program success.
• Common outcome measures included patient/caregiver satisfaction, hospital utilization, and place of death.
• The review synthesized findings from 21 qualitative, 25 quantitative, and 11 mixed-methods studies.

Conclusions:

• Specific components within CBPC programs are demonstrably effective and warrant wider implementation.
• Further research and testing are recommended in low- and middle-income countries and among vulnerable populations.
• Additional investigation into the cost-effectiveness of individual CBPC components is needed.