PMID: 18195339Jan 16, 2008Paper

Evidence for improving palliative care at the end of life: a systematic review

Annals of Internal Medicine
Karl A LorenzPaul Shekelle

Abstract

Many persons and their families are burdened by serious chronic illness in late life. How to best support quality of life is an important consideration for care. To assess evidence about interventions to improve palliative and end-of-life care. English-language citations (January 1990 to November 2005) from MEDLINE, the Database of Abstracts of Reviews of Effects, the National Consensus Project for Quality Palliative Care bibliography, and November 2005 to January 2007 updates from expert reviews and literature surveillance. Systematic reviews that addressed "end of life," including terminal illness (for example, advanced cancer) and chronic, eventually fatal illness with ambiguous prognosis (for example, advanced dementia), and intervention studies (randomized and nonrandomized designs) that addressed pain, dyspnea, depression, advance care planning, continuity, and caregiving. Single reviewers screened 24,423 titles to find 6381 relevant abstracts and reviewed 1274 articles in detail to identify 33 high-quality systematic reviews and 89 relevant intervention studies. They synthesized the evidence by using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) classification. Strong evidence supports t...Continue Reading

Associated Clinical Trials

Citations

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