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Effectiveness and cost effectiveness of palliative care interventions in people with chronic heart failure and their caregivers: a systematic review.
- Source :
- BMC Palliative Care; 11/23/2022, Vol. 21 Issue 1, p1-30, 30p
- Publication Year :
- 2022
-
Abstract
- Background: Chronic heart failure is a common condition, and its prevalence is expected to rise significantly over the next two decades. Research demonstrates the increasing multidimensional needs of patients and caregivers. However, access to palliative care services for this population has remained poor. This systematic review was to provide an evidence synthesis of the effectiveness and cost-effectiveness of palliative care interventions for people with chronic heart failure and their caregivers. Methods: Relevant publications were identified via electronic searches of MEDLINE, Embase, PsychInfo, CINAHL, CENTRAL and HMIC from inception to June 2019. Grey literature databases, reference list, and citations of key review articles were also searched. Quality was assessed using the Revised Cochrane Risk of Bias Tool. Results: Of the 2083 records, 18 studies were identified including 17 having randomised controlled trial (RCT) designs and one mixed methods study with an RCT component. There was significant heterogeneity in study settings, control groups, interventions delivered, and outcome measures used. The most commonly assessed outcome measures were functional status (n = 9), psychological symptoms (n = 9), disease-specific quality of life (n = 9), and physical symptom control (n = 8). The outcome measures with the greatest evidence for benefit included general and disease-specific quality of life, psychological symptom control, satisfaction with care, physical symptom control, medical utilisation, and caregiver burden. Moreover, the methodological quality of these studies was mixed, with only four having an overall low risk of bias and the remaining studies either demonstrating high risk of bias (n = 10) or showing some concerns (n = 4) due to small sample sizes and poor retention. Only two studies reported on economic costs. Both found statistically significant results showing the intervention group to be more cost effective than the control group, but the quality of both studies was at high risk of bias. Conclusions: This review supports the role of palliative care interventions in patients with chronic heart failure and their caregivers across various outcomes, particularly quality of life and psychological wellbeing. Due to the highly heterogeneous nature of palliative care interventions, it is not possible to provide definitive recommendations as to what guise palliative care interventions should take to best support the complex care of this population. Considerable future research, particularly focusing on quality of care after death and the caregiver population, is warranted. [ABSTRACT FROM AUTHOR]
- Subjects :
- HEART failure treatment
WELL-being
PSYCHOLOGY information storage & retrieval systems
CINAHL database
MEDICAL information storage & retrieval systems
HEALTH services accessibility
SYSTEMATIC reviews
FUNCTIONAL status
HEALTH outcome assessment
PATIENT satisfaction
BURDEN of care
COST effectiveness
PSYCHOLOGY of caregivers
QUALITY of life
QUALITY assurance
MEDLINE
NEEDS assessment
HEART failure
PALLIATIVE treatment
GREY literature
MEDICAL needs assessment
PSYCHOLOGICAL stress
Subjects
Details
- Language :
- English
- ISSN :
- 1472684X
- Volume :
- 21
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Palliative Care
- Publication Type :
- Academic Journal
- Accession number :
- 160371289
- Full Text :
- https://doi.org/10.1186/s12904-022-01092-2