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Effectiveness of End-of-Life Care in the Community in the Asian Context: A Systematic Review
Kanlayawee Anonjarn1,2, Yaowarat Matchim1
1Thammasat University, Pathumthani, Thailand.
Abstract:
Asian countries are prioritizing community and home end-of-life care (EoLC) as populations age and care preferences shift. Asian community-based EoLC's effectiveness is questionable due to cultural, institutional, and healthcare system challenges that affect access and quality. This systematic review seeks components. This makes EoLC effective in Asia. The disparities in care models, how they combine with healthcare institutions, and cultural and family variables are examined. Systematic review (PROSPERO ID: CRD42025644698). The electronic databases PubMed, CINAHL, Scopus, and ScienceDirect were searched in January 2025, evaluating community- or home-based EoLC programs in Asian countries. Twenty articles (8 qualitative studies, 2 quantitative randomized controlled trials, 3 quantitative non-randomized, 6 quantitative descriptive, and 1 mixed methods) fulfilled the inclusion criteria. The review identified the following key aspects of EoLC in Asian communities: symptom management, advance care planning (ACP), family and professional care, cultural sensitivity and spiritual care, healthcare system integration, education, and training. Although EoLC interventions have contributed substantially to improving care quality, the related evidence is inconclusive. Effective EoLC in Asian communities is related to culturally sensitive approaches, the crucial role of family and caregivers, and collaborative decision-making among patients, families, and healthcare professionals. Limited resource access, especially in rural locations, and inconsistent caregiver training and assistance remain issues. Healthcare, healthcare institutions, community resources, and standardized yet flexible criteria that respect spiritual, emotional, and cultural requirements are critically needed to provide fair, high-quality, and person-centered EoLC.
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