End-of-life care: Pathways and evidence

Massimo Costantini, Sara Alquati, Silvia Di Leo

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose of review Studies in different countries and settings of care have reported the quality of care for the dying patients as suboptimal. Care pathways have been developed with the aim of ensuring that dying patients and their family members received by health professionals the most appropriate care. This review presents and discusses the evidence supporting the effectiveness of the end-of-life care pathways. Recent findings Two Cochrane systematic reviews updated at June 2013 did not identify studies that met minimal criteria for inclusion. One randomized cluster trial aimed at assessing the effectiveness of the Liverpool Care Pathway in hospitalized cancer patients was subsequently published. The trial did not find a significant difference in the overall quality of care, the primary end-point, but two out of nine secondary outcomes - respect, dignity, and kindness, and control of breathlessness showed significant improvements. Afterwards, we did not find any other potentially eligible published study. Summary The overall amount of evidence supporting the dissemination of end-of-life care pathways is rather poor. One negative randomized trial suggests the pathways have the potential to reduce the gap between hospital and hospices. Further research is needed to understand the potential benefit of end-of-life care pathways.

Original languageEnglish
Pages (from-to)399-404
Number of pages6
JournalCurrent Opinion in Supportive and Palliative Care
Volume8
Issue number4
DOIs
Publication statusPublished - 2014

Keywords

  • Care of the dying
  • Care pathway
  • Effectiveness
  • End-of-life
  • Review

ASJC Scopus subject areas

  • Oncology
  • Medicine(all)
  • Critical Care and Intensive Care Medicine
  • Oncology(nursing)

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