Table 1 Included records relative to components described

Blackhall et al. 2016 [18] USA

Quantitative pre-post intervention prospective cohort measuring timing of referral to outpatient palliative care and impact on end-of-life care

207 patients with advanced cancer

Patients involved in the intervention had fewer hospitalisations at the end of life.

X

X

Calton et al. 2017 [19]

USA

Longitudinal prospective cohort (6-month community bridge pilot gave patients access to home-based palliative care)

17 patients with cancer and complex care needs

Home-based palliative care filled an unmet need for patients with advanced, metastatic cancer who desired ongoing cancer treatment, but were also in need of intensive end-of-life home services. Community bridge providers acted as crisis managers and reporters for oncologists.

X

X

X

X

X

Casotto et al. 2017 [20]

Italy

Retrospective cohort

17,604 decedent cancer patients

A well-integrated palliative care approach can be effective in further reducing the percentage of patients who spent many days in hospital and/or undergo frequent and inopportune changes of their care setting during their last month of life.

X

X

X

Duffy et al. 2018 [21]

USA

Single-centre, prospective, pilot initiative

27 cancer patients

The initiative used a hospice discharge checklist, pharmacist-led discharge medication reconciliation in consultation with the primary team responsible for inpatient care, review of discharge prescriptions, and facilitation of bedside delivery of discharge medications. There was significant (P = .035) improvement in hospice organizations’ perceptions of discharge readiness.

X

X

Malmstrom et al. 2013 [22]

Sweden

Semi-structured focus-group interviews and conventional qualitative content analysis

17 (patients who had undergone oesophageal cancer surgery)

Patients need a plan for the future, help in navigating the healthcare system and the provision of clear, honest information and a system that overarches the gap between in and out-patient care. Patients need support that starts at the hospital and continues to out-patient care. Support should focus on: developing a plan for the future, providing patients with information that will enable them to understand their new life situation.

X

X

X

X

Johansen and Ervik 2022 [23]

Norway

Qualitative focus group and interview study + thematic analysis (realist paradigm)

52 (15 district nurses, 15 oncology nurses, 17 GPs, 5 physiotherapists / occupational therapists)

“Talking together” was perceived as the optimal form of collaboration. Nurses and GPs had similar perceptions of their worst-case scenario in primary palliative care: the sudden arrival after working hours of a sick patient lacking information. Lack of communication, both locally and between specialist and primary care, was a key factor in the worst-case patient scenarios for GPs and nurses working in primary palliative care.

X

X

X

X

Ko et al. 2014 [24]

Belgium, Netherlands, Italy and Spain

Mortality follow-back weekly questionnaires + statistical analysis of cross-country variations

2037 (patients with advanced cancer in the last three months of life)

Over half of patients had at least one transition in care setting within the last three months of life. One third of patients in 3 of the countries had a last week hospital admission and died there. This symptom burden in the last week of life indicates the need for further integration of palliative care into oncology.

X

X

X

Murakami et al. 2022 [25]

Japan

Quantitative - questionnaire post intervention

151 (84 staff, 67 bereaved families)

Using an information sharing tool for GPs, patients, families and a specialist palliative care outreach team, led to an increase in home deaths. For the survey involving the medical staff, factors, such as “improved awareness of an multidisciplinary team,” were identified. For the survey involving the bereaved families, factors, such as “improvement of communications between patients and healthcare professionals,” were identified.

X

X

X

X

Noble, B. et al. 2015 [26]

UK

Mixed methods - retrospective analysis of secondary-care use in the last year of life; financial evaluation; qualitative interviews; a postal survey of General Practices; and a postal survey of bereaved caregivers. To evaluate The Midhurst Macmillan Specialist Palliative Care Service (MMSPCS) - a UK, medical consultant-led, multidisciplinary team aiming to provide round-the-clock advice and care, including specialist interventions, in the home, community hospitals and care homes.

232 GP practices

102 bereaved carers

Midhurst service patients spent less time in hospital and had fewer hospital attendances. Outpatient attendances were higher for the Midhurst group. Bereaved carers rated home services good or excellent (83%). 58% died at home, 85% felt their relative died in the right place. 90% found bereavement care helpful. Qualitative themes included importance of working collaboratively with external services and to establish relationships; staff taking into account family and social context; and a non-hierarchical dynamic across professional staff, volunteers and family members and a willingness to learn.

X

X

X

X

Nordly et al. 2019 [27]

Denmark

Patients were randomised to either a systematic fast-track transition from oncological treatment to home-based specialised palliative care reinforced with a dyadic psychological intervention plus standard cancer care or standard cancer care plus on-demand specialized palliative care

340 patients

Findings indicated that the intervention had no effect on time spent at home or place of death. However, the intervention resulted in some improvement in quality of life, social functioning and emotional functioning after 6 months.

X

X

Tan, Woan Shin et al. 2016 [28]

Singapore

Retrospective study of two cohorts - intervention group and historical comparison group

321 patients

Hospital deaths were significantly lower for programme participants. The intervention group had significantly lower emergency department visits at 30 days, 60 days and 90 days prior to death. Similar results were found for the number of hospitalisations at 30 days, 60 days and 90 days prior to death, demonstrating that integrating services between acute care and home hospice care could reduce acute care service usage.

X

X

X

X

von Heymann-Horan et al. 2018 [29]

Denmark

Randomised control trial of home-based specialist palliative care, known as the Domus model - reporting on feasibility and acceptability

441 (251 patients, 190 caregivers)

Integration of psychological support sought to facilitate patients chances of receiving care and dying at home, by alleviating distress in patients and caregivers. Enrolment in the trial and uptake of the intervention indicated it was acceptable to patients and caregivers. The intervention focussed on dyads, psychological distress, and existential concerns, multidisciplinary collaboration and psychological interventions offered according to need.

X

X

X

X

Zemplenyi et al. 2020 [30]

Hungary

Documentary and qualitative interviews with stakeholders - to understand how stakeholders think about key features using content analysis

17 (4 managers, 3 physicians, 4 HCP, 4 informal, 2 patients)

Integrated, multidisciplinary and patient-centred care approach was well-received, with an increasing number of requests for consultations. From the patient pathway management across providers (e.g. from inpatient care to homecare) a higher level of coordination could be achieved in continuity of care for seriously-ill patients. However, the regulatory framework to integrate this has only partially been established.

X

X

X

Kerin Adelson et al. 2017 [31]

USA

Prospective cohort study with an advanced solid tumour, prior hospitalization within 30-day, hospitalisation of 7 or more days, or active symptoms. Patients who met the criteria received automatic palliative care consultation.

Preintervention (48 patients)

Intervention (65 patients)

Intervention group had increased palliative care consultations and hospice referrals, with declines in 30-day readmission rates and receipt of chemotherapy after discharge. Overall increase in support measures following discharge. Length of stay was unaffected.

X

X

X

X

X