Understanding place of death for patients with non malignant disease: a systematic literature review

Award Number
08/1813/257
Award Type
SDO - Knowledge Mobilisation
Programme
Health and Social Care Delivery Research
Status / Stage
Completed
Dates
1 January 2010 -
1 April 2011
Duration (calculated)
01 years 03 months
Funder(s)
NIHR
Funding Amount
£113,944.00
Funder/Grant study page
NIHR
Contracted Centre
King's College London
Principal Investigator
Professor Fliss Murtagh
PI Contact
F.Murtagh@hull.ac.uk
PI ORCID
0000-0003-1289-3726
WHO Catergories
Models across the continuum of care
Tools and methodologies for interventions
Disease Type
Dementia (Unspecified)

CPEC Review Info
Reference ID176
ResearcherReside Team
Published12/06/2023

Data

Award Number08/1813/257
Status / StageCompleted
Start Date20100101
End Date20110401
Duration (calculated) 01 years 03 months
Funder/Grant study pageNIHR
Contracted CentreKing's College London
Funding Amount£113,944.00

Abstract

Compared with advanced cancer, those with advanced non-malignant conditions spend more time in acute hospital care and are less likely to die at home. Their preferences for place of care/death may be less often met. Planning equitable care for these patients is increasingly important and needs to be evidence-based to deliver best outcomes. Aim: To systematically identify, appraise, synthesise and report the evidence on 1) the extent to which people with advanced non-malignant conditions want to die at home, 2) what determines their preferences for place of care/death, 3) which factors are associated with place of death, and 4) key transitions in end-of-life care. This review will focus on six conditions: Chronic Cardiac Failure, Chronic Obstructive Pulmonary Disease, Dementia, Stroke, End-stage Kidney Disease, and Long-term Neurological Conditions. Methods: Through a systematic literature review, to identify, critically appraise the evidence in terms of the quantity, quality, and strength, synthesize and report it and identify gaps in the existing evidence. A comprehensive search will be conducted to identify evidence across preferences, factors, and transitions. Key transitions in care will be defined early in the project, and are expected to include transitions in setting of care (such as admission to hospital from home), and transitions in focus of care (such as from curative to palliative treatment). Outcomes: Findings will be synthesized, reported, and compared across ages and conditions. Factors associated with place of death will be analysed for direction of effect (for/against home death) and the relative impact of different health and social care resources on place of death will be reported, using odds ratios where possible. A meta-ethnography will integrate the qualitative evidence on what determines or changes preferences for place of care/death. Detailed recommendations will be made to inform practice and improve care, and highlight future research needs.

Aims

This project aims to review, with rigour and detail, the existing research on preferences regarding place of care and death, and factors influencing place of death for those with non cancer conditions, to inform better delivery of care, and to identify research gaps.